Basic Information
| Provider Information | |||||||||
| NPI: | 1013415546 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMITRANO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | RICHARD | ||||||||
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| Credential: | MSCCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 435 4TH ST | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121805324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182716777 | ||||||||
| FaxNumber: | 5182745438 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 PHILIP ST | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122071413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186713777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2018 | ||||||||
| LastUpdateDate: | 01/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 028431 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.