Provider Demographics
NPI:1992258180
Name:AMARAL, SANITA (PA)
Entity type:Individual
Prefix:
First Name:SANITA
Middle Name:
Last Name:AMARAL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SANITA
Other - Middle Name:
Other - Last Name:COSIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3018 BROADWAY APT 1J
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2623
Mailing Address - Country:US
Mailing Address - Phone:602-318-0992
Mailing Address - Fax:
Practice Address - Street 1:3701 BROADWAY
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103
Practice Address - Country:US
Practice Address - Phone:929-265-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant