Basic Information
| Provider Information | |||||||||
| NPI: | 1043664246 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAILO | ||||||||
| FirstName: | AMBILY | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2624 BUFFALO AVE | ||||||||
| Address2: | |||||||||
| City: | FEASTERVILLE TREVOSE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190536706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2674718726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1205 LANGHORNE NEWTOWN RD | ||||||||
| Address2: | SUITE 309 | ||||||||
| City: | LANGHORNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190471219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157411963 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2016 | ||||||||
| LastUpdateDate: | 04/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | SP016094 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.