Provider Demographics
NPI:1861248635
Name:FUNARO, AMANDA HAILEY
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:HAILEY
Last Name:FUNARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BARKLEY LN
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-1501
Mailing Address - Country:US
Mailing Address - Phone:631-707-6738
Mailing Address - Fax:
Practice Address - Street 1:1 CRAIG B GARIEPY AVE
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2820
Practice Address - Country:US
Practice Address - Phone:631-650-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist