Provider Demographics
NPI:1548314743
Name:MAYER, AMY (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LISA
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3300 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2387
Mailing Address - Country:US
Mailing Address - Phone:315-663-5206
Mailing Address - Fax:
Practice Address - Street 1:3300 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2387
Practice Address - Country:US
Practice Address - Phone:315-663-5206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY463057-1163WH0200X
NYF401298-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health