Individual
AMANDA RUDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 UNIVERSITY DR, MC A410, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
1501 LEHIGH ST, SUITE 201, ALLENTOWN, PA 18103-3880
(610) 289-0114
(610) 289-4282
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OC-007055-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01852355
—
PA
Enumeration date
02/22/2007
Last updated
01/14/2011
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