Provider Demographics
NPI:1326394040
Name:TING, AMANDA ELIZABETH (PT)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:TING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 W 117TH ST
Mailing Address - Street 2:APT 4H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2109
Mailing Address - Country:US
Mailing Address - Phone:919-621-7154
Mailing Address - Fax:
Practice Address - Street 1:311 W 43RD ST
Practice Address - Street 2:SUITE 405
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6413
Practice Address - Country:US
Practice Address - Phone:212-245-7278
Practice Address - Fax:212-245-7461
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist