Provider Demographics
NPI:1073778619
Name:LIVINGSTON, AMY BETH (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:BETH
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:4401 FRANCIS LEWIS BLVD-STE L2A
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3028
Mailing Address - Country:US
Mailing Address - Phone:718-717-0291
Mailing Address - Fax:718-717-0295
Practice Address - Street 1:4401 FRANCIS LEWIS BLVD - STE. L2A
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3028
Practice Address - Country:US
Practice Address - Phone:718-717-0291
Practice Address - Fax:718-717-0295
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010215363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant