Individual
AMY PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
3550 MARKET ST, PHILADELPHIA, PA 19104-3329
(917) 678-1518
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MB12023000
NJ
208000000X
Pediatrics Physician
Primary
OS022805
PA
2080A0000X
Pediatric Adolescent Medicine Physician
OS022805
PA
Other
Enumeration date
04/21/2017
Last updated
10/13/2024
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