Provider Demographics
NPI:1154954535
Name:AMAYA, MILTON BENNET (PTA)
Entity type:Individual
Prefix:MR
First Name:MILTON
Middle Name:BENNET
Last Name:AMAYA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 563
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-0563
Mailing Address - Country:US
Mailing Address - Phone:302-265-5299
Mailing Address - Fax:
Practice Address - Street 1:316 N MORRIS ST
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-8400
Practice Address - Country:US
Practice Address - Phone:302-265-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ2-0001264225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant