Provider Demographics
NPI:1083052302
Name:PARSONS, AMANDA HERON (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:HERON
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 DUANE ST
Mailing Address - Street 2:7C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3398
Mailing Address - Country:US
Mailing Address - Phone:917-576-6940
Mailing Address - Fax:
Practice Address - Street 1:166 DUANE ST
Practice Address - Street 2:7C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3398
Practice Address - Country:US
Practice Address - Phone:917-576-6940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242366251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare