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NPI Code Detail

MEDICARE: AMY M MOSS PAC

MEDICARE: AMY M MOSS PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantC0003000MD

General Provider Information

NPI Number : 1861479487
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY M MOSS PAC
Provider Business Mailing Address
First Line : 1011 REED AVE
Second Line : SUITE 300
City : WYOMISSING
State : PA
Zip : 19610-2002
Country : US
Telephone Number : 610-374-4401
Fax Number : 610-374-7916
Provider Business Practice Location Address
First Line : 1011 REED AVE
Second Line : SUITE 300
City : WYOMISSING
State : PA
Zip : 19610-2002
Country : US
Telephone Number : 610-374-4401
Fax Number : 610-374-7916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 12/05/2016

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Directions to “ AMY M MOSS PAC” Practice Location

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