Provider Demographics
NPI:1437665031
Name:NAMORATO, AMANDA (MA CCC-SLP, TSSLD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:NAMORATO
Suffix:
Gender:F
Credentials:MA CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2562
Mailing Address - Country:US
Mailing Address - Phone:631-332-9892
Mailing Address - Fax:
Practice Address - Street 1:1111 WAVERLY AVE
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742
Practice Address - Country:US
Practice Address - Phone:631-471-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist