MEDICARE: AMBER GARCIA

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist		PA

General Provider Information

NPI Number	:	1871110650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER GARCIA

Provider Business Mailing Address
First Line	:	100 FRONT ST.
Second Line	:	280
City	:	WEST CONSHOHOCKEN
State	:	PA
Zip	:	19122
Country	:	US
Telephone Number	:	215-860-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 FRONT ST STE 280
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2891
Country	:	US
Telephone Number	:	215-860-0100
Fax Number	:

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

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	06/29/2020

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Directions to “ AMBER GARCIA ” Practice Location

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