Healthcare Provider Details

I. General information

NPI: 1174905251
Provider Name (Legal Business Name): AMBER CHRISTINE BAISZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD CROZER PEDIATRICS, 1 POB, SUITE 205
CHESTER PA
19013-3902
US

IV. Provider business mailing address

1 MEDICAL CENTER BLVD PEDIATRIC RESIDENCY, 3 EAST
CHESTER PA
19013-3902
US

V. Phone/Fax

Practice location:
  • Phone: 610-619-7410
  • Fax: 610-876-8483
Mailing address:
  • Phone: 610-447-6680
  • Fax: 610-447-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD465531
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: