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General NPI Number Information
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NPI Number | 1851441323
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Entity Type | Individual
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Provider Name | AMY S WIRTNER MD
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR
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City | LEWISBURG
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State | PA
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Zip | 17837-9350
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Country | US
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Telephone | 570-522-2640
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Fax | 570-768-3921
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Provider Business Mailing Address
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Address Line | 407 AIRPORT EXEC. PARK
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City | NANUET
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State | NY
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Zip | 10954
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 236945
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD455734
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License Number State | PA
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