Individual
AMANDA LEE MADURSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001930
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022032200003
—
PA
05
—
1022032200004
—
PA
05
—
1022032200005
—
PA
Enumeration date
08/21/2007
Last updated
05/24/2023
Update your record
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