Individual
AMANDA MARIE FELLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
860 1ST AVE STE 8B, KING OF PRUSSIA, PA 19406-4033
(844) 337-6362
(646) 665-3604
Mailing address
4170 CITY AVE, PHILADELPHIA, PA 19131-1610
(215) 871-6100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA062795
NJ
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/01/2021
Last updated
12/19/2023
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