MEDICARE: DR. AMANDA M. LAIRD M.D.

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
1	208600000X	Surgery Physician	2002-00135	NC
2	208600000X	Surgery Physician	0200135	NC
3	208600000X	Surgery Physician	4301096481	MI
4	208600000X	Surgery Physician	P1559	TX
5	208600000X	Surgery Physician	25MA10051400	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1851377576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA M. LAIRD M.D.

Provider Business Mailing Address
First Line	:	320 E 58TH ST
Second Line	:	APT 3H
City	:	NEW YORK
State	:	NY
Zip	:	10022-2220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2404
Country	:	US
Telephone Number	:	718-920-4059
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/01/2025

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