Individual
AMANDA ROUSLIN KOHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 WALNUT ST STE 702, PHILADELPHIA, PA 19107-5563
(215) 955-2165
(215) 923-7957
Mailing address
1100 WALNUT ST STE 702, PHILADELPHIA, PA 19107-5563
(215) 955-2165
(215) 923-7957
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014268
NY
363A00000X
Physician Assistant
MA057526
PA
363AS0400X
Surgical Physician Assistant
Primary
MA057526
PA
Other
Enumeration date
09/27/2010
Last updated
08/11/2020
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