Provider Demographics
NPI:1588031744
Name:PICIOLI, AMANDA (AUD, MED)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:PICIOLI
Suffix:
Gender:F
Credentials:AUD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 LOMB MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5604
Mailing Address - Country:US
Mailing Address - Phone:585-475-6384
Mailing Address - Fax:
Practice Address - Street 1:52 LOMB MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5604
Practice Address - Country:US
Practice Address - Phone:585-475-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002051-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist