Individual
MRS. AMY MICHELE DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
67 WALNUT AVE, CLARK, NJ 07066-1640
(908) 654-3377
(908) 654-4044
Mailing address
12 EXETER RD, CLARK, NJ 07066-2506
(908) 248-8795
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00220800
NJ
Other
Enumeration date
08/17/2009
Last updated
02/23/2023
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