Provider Demographics
NPI:1215493812
Name:TSANG, AMANDA (FNP-BC, MPH)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:TSANG
Suffix:
Gender:F
Credentials:FNP-BC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W 168TH ST RM 438
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-305-3746
Mailing Address - Fax:212-305-2026
Practice Address - Street 1:710 W 168TH ST RM 438
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-305-3746
Practice Address - Fax:212-305-2026
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344787-01363LF0000X
NY740069-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse