Amy Ilardi, REGISTERED NURSE

Individual provider Active NPI EEG Specialist/Technologist · Phoenix, NY

NPI 1649020132 · NPPES record last updated Mar 31, 2025

Key facts

NPI
1649020132
Entity type
Individual (NPI type 1)
Primary specialty
EEG Specialist/Technologist 246ZE0500X
Practice address
86 State St
Phoenix, NY 13135-2273
Phone
(315) 529-3585
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
669715NYMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 669715 NY
Psychiatric/Mental Health Registered Nurse 163WP0808X 669715 NY
Health & Wellness Coach 171400000X
EEG Specialist/Technologist 246ZE0500X NY Yes

Addresses

Primary practice location

86 State St
Phoenix, NY 13135-2273

Mailing address

86 State St
Phoenix, NY 13135-2273
Phone (315) 529-3585

Other providers in Phoenix, NY

All providers in Phoenix, NY · EEG Specialist/Technologist in New York

Sources for this page

Verify at the official NPI Registry.