Provider Demographics
NPI:1982212791
Name:LEVY, AMANDA B (AUD, HAD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:LEVY
Suffix:
Gender:F
Credentials:AUD, HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3411
Mailing Address - Country:US
Mailing Address - Phone:607-734-0494
Mailing Address - Fax:607-734-0880
Practice Address - Street 1:446 E WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3411
Practice Address - Country:US
Practice Address - Phone:607-734-0494
Practice Address - Fax:607-734-0880
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000063770237700000X
NY002941231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist