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Individual

MRS. AMY PATRICIA REARDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(667) 214-1718
(410) 328-5147
Mailing address
PO BOX 64226, BALTIMORE, MD 21264-4226
(667) 214-1734
(410) 706-6976

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001009954
NC
363A00000X
Physician Assistant
Primary
C0008477
MD
363A00000X
Physician Assistant
PAT 9108152
FL

Other

Enumeration date
09/23/2014
Last updated
04/24/2023
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