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NPI Code Detail

MEDICARE: AMANDA MOMENZADEH

MEDICARE: AMANDA MOMENZADEH
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
1183500000XPharmacist72843CA

General Provider Information

NPI Number : 1871962134
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MOMENZADEH
Provider Business Mailing Address
First Line : 900 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-1202
Country : US
Telephone Number : 414-805-3000
Fax Number :
Provider Business Practice Location Address
First Line : 900 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-1202
Country : US
Telephone Number : 414-805-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2015
Last Update Date : 09/29/2021

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Directions to “ AMANDA MOMENZADEH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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