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NPI Code Detail

MEDICARE: AMANDA FUNICIELLO

MEDICARE: AMANDA FUNICIELLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1144986290
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA FUNICIELLO
Provider Business Mailing Address
First Line : 4380 MAIN ST
Second Line :
City : AMHERST
State : NY
Zip : 14226-3544
Country : US
Telephone Number : 800-462-7652
Fax Number :
Provider Business Practice Location Address
First Line : 1050 NIAGARA ST
Second Line :
City : BUFFALO
State : NY
Zip : 14213-2001
Country : US
Telephone Number : 716-710-4393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2021
Last Update Date : 05/17/2026

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Directions to “ AMANDA FUNICIELLO ” Practice Location

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