Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | XA5051610 | NY |
Y | 207RA0401X | Internist - Addiction Medicine | $$$$$$$$$ | NY |
NPI | 1124031265 |
---|---|
Provider Name | Dr. Felicitas G Amador |
First Address | New York, NY 10010-7401 |
Second Address | New York, NY 10010-7401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 27/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02080284 | (05) | NY |
282131 | (02) | NY |