Agley, Amanda Lynn

Agley, Amanda Lynn is an individual health care provider with primary practice located at 830 Washington St , Watertown NY 13601-4034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Agley, Amanda Lynn can be contacted via phone (315) 755-3670.

Contact Information

Primary practice address
830 Washington St Watertown NY 13601-4034
Phone: (315) 755-3670
Fax: (315) 755-3671
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 023549 New York

Profile Details

NPI number 1730748419
LBN Legal business name Agley, Amanda Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2019
Last updated Feb 15th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730748419 NPPES
New York MEDICAID 05967193

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