Provider Demographics
NPI:1649621509
Name:DIAMOND, AMANDA R (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:R
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 SHAKER RUN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2455
Mailing Address - Country:US
Mailing Address - Phone:518-588-0560
Mailing Address - Fax:
Practice Address - Street 1:204 S BROADWAY # 303
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-4570
Practice Address - Country:US
Practice Address - Phone:518-226-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2024-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical