MEDICARE: AMANDA L ORSZULAK PA

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
1	363AM0700X	Medical Physician Assistant	PA3986	MA

General Provider Information

NPI Number	:	1215249248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA L ORSZULAK PA

Provider Business Mailing Address
First Line	:	370 FAUNCE CORNER RD
Second Line	:
City	:	NORTH DARTMOUTH
State	:	MA
Zip	:	02747-1271
Country	:	US
Telephone Number	:	508-999-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 FAUNCE CORNER RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-1271
Country	:	US
Telephone Number	:	508-999-5666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	11/19/2010

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