Individual
AMANDA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-5369
(610) 402-5959
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 884-0469
(484) 884-0628
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA059493
PA
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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