Healthcare Provider Details

I. General information

NPI: 1720280266
Provider Name (Legal Business Name): NORIYUKI AMEMIYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR MAILCODE A410
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

500 UNIVERSITY DR MAILCODE A410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-1159
  • Fax: 717-531-7269
Mailing address:
  • Phone: 717-531-1159
  • Fax: 717-531-7269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberLT000632
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberLT000632
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberLT000632
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierLT000632
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMED LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: