Provider Demographics
NPI:1063909323
Name:MILES, AMANDA L (NYCPS)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:L
Last Name:MILES
Suffix:
Gender:F
Credentials:NYCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2237
Mailing Address - Country:US
Mailing Address - Phone:607-316-4599
Mailing Address - Fax:
Practice Address - Street 1:139 RIVER ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2237
Practice Address - Country:US
Practice Address - Phone:607-316-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-21
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYCPS-354175T00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist