Individual
DR. AMANDA MORTILLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-7000
Mailing address
439 N 13TH ST, APT 1B, PHILADELPHIA, PA 19123-3626
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT207433
PA
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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