IndividualActive
Amanda Formato, PA-C, ATC
NPI 1356814842 · Surgical Physician Assistant · Bethpage, NY
Provider details
- NPI number
- 1356814842
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C, ATC
- Sex
- Female
- Sole proprietor
- No
- License
- PA56656 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone: (516) 579-6000
Approximate (ZIP-level) locationGet directions
Mailing address
3868 Green Pl
Bethpage, NY 11714-4208
Registry dates
- Enumerated
- 2019-01-07
- Last updated
- 2026-03-27
- Certified
- 2026-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.