Individual
AMY TANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 PROSPECT AVE STE 702, HACKENSACK, NJ 07601-1974
(908) 359-8980
Mailing address
20 PROSPECT AVE STE 702, HACKENSACK, NJ 07601-1974
(908) 359-8980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017012-1
NY
363A00000X
Physician Assistant
Primary
25MP00316100
NJ
Other
Enumeration date
12/20/2013
Last updated
09/19/2019
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