Provider Demographics
NPI:1205149119
Name:SINI, AMANDA M (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:SINI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2642
Mailing Address - Country:US
Mailing Address - Phone:631-638-2375
Mailing Address - Fax:
Practice Address - Street 1:2701 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2642
Practice Address - Country:US
Practice Address - Phone:631-638-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001393367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife