Provider Demographics
NPI:1497645071
Name:HUEBLER, AMANDA ROSE (MS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ROSE
Last Name:HUEBLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2040
Mailing Address - Country:US
Mailing Address - Phone:718-598-7033
Mailing Address - Fax:718-598-7033
Practice Address - Street 1:70 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2040
Practice Address - Country:US
Practice Address - Phone:718-598-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist