Provider Demographics
NPI:1952770885
Name:FIORI, AMANDA LYNN (RN)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LYNN
Last Name:FIORI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:LYNN
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:118 KINGS PARK DR APT C
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2718
Mailing Address - Country:US
Mailing Address - Phone:315-491-2617
Mailing Address - Fax:
Practice Address - Street 1:118 KINGS PARK DR APT C
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2718
Practice Address - Country:US
Practice Address - Phone:315-491-2617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 625339163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse