National Provider Identifier
Amanda Elizabeth Didas, PA-C
Amanda Elizabeth Didas, PA-C is listed in the NPPES registry with a primary specialty of Pediatric Otolaryngology Physician in Rochester, NY and a listed phone number of (585) 758-5700.
Profile Overview
- NPI
- 1851558969
- Provider Type
- Individual
- Primary Specialty
- Pediatric Otolaryngology Physician
- Enumeration Date
- May 19, 2008
- Last Updated
- June 29, 2023
Practice Location
- 125 Lattimore RD
- Rochester, NY 14620-4159
Phone: (585) 758-5700
Mailing Address
- 601 Elmwood Ave Box 629
- Rochester, NY 14642-0001
Specialties
- Pediatric Otolaryngology Physician (207YP0228X)
- Pediatric Otolaryngology Physician (207YP0228X)
Full Record
- NPI
- 1851558969
- Entity Type
- Individual
- Last Name
- Didas
- First Name
- Amanda
- Middle Name
- Elizabeth
- Name Prefix
- Mrs.
- Credential
- PA-C
- Provider Other Last Name
- Coburn
- Provider Other First Name
- Amanda
- Provider Other Middle Name
- Elizabeth
- Provider Other Credential Text
- PA-C
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 601 Elmwood Ave Box 629
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 758-5700
- Practice Street Address
- 125 Lattimore RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-4159
- Practice Country
- US
- Practice Phone
- (585) 758-5700
- Enumeration Date
- May 19, 2008
- Last Updated
- June 29, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 15, 2021
- Taxonomies
- Pediatric Otolaryngology Physician (207YP0228X), Pediatric Otolaryngology Physician (207YP0228X)