Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | SP024182 | PA |
NPI | 1033884853 |
---|---|
Provider Name | Amanda Ruth Henry |
First Address | Perkasie, PA 18944-1580 |
Second Address | Abington, PA 19001-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |