Provider Demographics
NPI:1295170785
Name:BING, AMANDA JANINE (LPN)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:JANINE
Last Name:BING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13852 231ST ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2833
Mailing Address - Country:US
Mailing Address - Phone:347-954-6795
Mailing Address - Fax:
Practice Address - Street 1:13852 231ST ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2833
Practice Address - Country:US
Practice Address - Phone:347-954-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313960164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse