Provider Demographics
NPI:1720213275
Name:FRANK, AMATINA M
Entity Type:Individual
Prefix:
First Name:AMATINA
Middle Name:M
Last Name:FRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5566 JERICO ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST BETHANY
Mailing Address - State:NY
Mailing Address - Zip Code:14054-9619
Mailing Address - Country:US
Mailing Address - Phone:716-207-6927
Mailing Address - Fax:
Practice Address - Street 1:5566 JERICO ROAD
Practice Address - Street 2:
Practice Address - City:EAST BETHANY
Practice Address - State:NY
Practice Address - Zip Code:14054-9619
Practice Address - Country:US
Practice Address - Phone:716-207-6927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008908-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist