Amanda Leigh Barra, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

I-059901 Issued in NY

Practice address

101 Nicolls Rd # Level1
Stony Brook, NY 11794-7007

Phone

(631) 444-2860

NPI assigned

Jul 7, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Amanda Leigh Waldeck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1164100319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD # LEVEL1",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947007",
            "telephone_number": "631-444-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD # LEVEL1",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947007",
            "telephone_number": "631-444-2860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Main St",
            "address_purpose": "LOCATION",
            "city": "Kings Park",
            "state": "NY",
            "postal_code": "117543426",
            "country_code": "US",
            "telephone_number": "631-361-3540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRA",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I-059901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WALDECK",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Barnett Kradjian, DO
• John P Barnett, DMD
• Elizabeth A Baron, PA-C
• Ciara Christine Barone
• Amanda Baroutjian, MD
• Susan Barra, RN
• David Barrera Jr., MD
• Layla Cristal Barrera, DO
• Jorden Barrow, MD
• Meital Barzideh, M.D.

• Pharmacist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.