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General NPI Number Information
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NPI Number | 1619440831
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Entity Type | Individual
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Provider Name | MR. AMAR VIJAY DAVE
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Gender | Male
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2615 TULIP ST APT B
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City | PHILADELPHIA
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State | PA
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Zip | 19125-1818
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Country | US
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Telephone | 847-757-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 7816 MINE RUN RD
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City | HANOVER
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State | MD
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Zip | 21076-2601
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Country | US
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Telephone | 215-909-3669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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