Provider Demographics
NPI:1841414877
Name:VANDERCLAY, AMANDA CZIGANY (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CZIGANY
Last Name:VANDERCLAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:CZIGANY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1500 EAST 2ND STREET #206
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-789-7000
Mailing Address - Fax:775-789-7040
Practice Address - Street 1:1500 EAST 2ND STREET #206
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-789-7000
Practice Address - Fax:775-789-7040
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14290208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM134189Medicare UPIN