Kupst, Amanda Mary

Kupst, Amanda Mary is an individual health care provider with primary practice located at 500 Portion Rd Ste 11 , Lake Ronkonkoma NY 11779-4587. 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. Kupst, Amanda Mary can be contacted via phone (631) 648-0101.

Contact Information

Primary practice address
500 Portion Rd Ste 11 Lake Ronkonkoma NY 11779-4587
Phone: (631) 648-0101
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 13205879-1206 Utah

Profile Details

NPI number 1467927764
LBN Legal business name Kupst, Amanda Mary
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2018
Last updated Aug 23rd, 2023 - 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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