Provider Demographics
NPI:1316781982
Name:PINKERTON, AMANDA COURTNEY (OD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:COURTNEY
Last Name:PINKERTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 ANNIE WAY
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2561
Mailing Address - Country:US
Mailing Address - Phone:717-468-6884
Mailing Address - Fax:
Practice Address - Street 1:141 TUCKAHOE RD STE 460
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-3845
Practice Address - Country:US
Practice Address - Phone:856-237-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00196500152W00000X
NJ27OA00729100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist