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NPI Code Detail

MEDICARE: AMANDA MARIE BISHOP

MEDICARE: AMANDA MARIE BISHOP
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
1164W00000XLicensed Practical Nurse285441-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730495292
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE BISHOP
Provider Business Mailing Address
First Line : 138 CECIL MALONE DR
Second Line :
City : ITHACA
State : NY
Zip : 14850-5124
Country : US
Telephone Number : 607-273-0466
Fax Number :
Provider Business Practice Location Address
First Line : 138 CECIL MALONE DR
Second Line :
City : ITHACA
State : NY
Zip : 14850-5124
Country : US
Telephone Number : 607-273-0466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2010
Last Update Date : 08/23/2010

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Directions to “ AMANDA MARIE BISHOP ” Practice Location

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