Individual
MRS. MADISON ANN MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE STREET, 3 SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-3487
(215) 349-5534
Mailing address
3400 SPRUCE STREET, 3 SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-3487
(215) 349-5534
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
25MP00603200
NJ
363AS0400X
Surgical Physician Assistant
Primary
MA060311
PA
Other
Enumeration date
01/17/2019
Last updated
03/11/2026
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