Basic Information
| Provider Information | |||||||||
| NPI: | 1972731156 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMALFI | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 973 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146072216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852441000 | ||||||||
| FaxNumber: | 5852714786 | ||||||||
| Practice Location | |||||||||
| Address1: | 973 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146072216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852441000 | ||||||||
| FaxNumber: | 5852714786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2009 | ||||||||
| LastUpdateDate: | 01/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 279428 | NY | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 04320545 | 05 | NY | MEDICAID |