Provider Demographics
NPI:1952624462
Name:BAYSINGER, AMANDA NICOLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NICOLE
Last Name:BAYSINGER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:NICOLE
Other - Last Name:SLIVIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:314 S MANNING BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1708
Mailing Address - Country:US
Mailing Address - Phone:518-453-2273
Mailing Address - Fax:518-437-5554
Practice Address - Street 1:314 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1708
Practice Address - Country:US
Practice Address - Phone:518-453-2273
Practice Address - Fax:518-437-5554
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400018677Medicare PIN