Individual
AMANDA CIAVAGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
212 CREEK CROSSING BLVD, HAINESPORT, NJ 08036-2766
(609) 267-1004
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
25MP00738200
NJ
363AS0400X
Surgical Physician Assistant
—
NJ
Other
Enumeration date
09/26/2022
Last updated
11/06/2024
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