Individual
THARA SARASWATHI AMILINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 SOUTH FRONT STREET, BRADY 3, HARRISBURG, PA 17104
(717) 231-8775
Mailing address
205 S FRONT ST, HARRISBURG, PA 17104-1619
(717) 231-8323
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD478854
PA
207P00000X
Emergency Medicine Physician
Primary
ME163575
FL
207P00000X
Emergency Medicine Physician
MT219183
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT219183
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103698702
—
PA
01
—
2I7958
MEDICARE
PA
Enumeration date
06/24/2019
Last updated
05/20/2024
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