Basic Information
| Provider Information | |||||||||
| NPI: | 1053627679 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLLA | ||||||||
| FirstName: | AMANDEEP | ||||||||
| MiddleName: | SINGH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 WALNUT ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159551234 | ||||||||
| FaxNumber: | 2159236792 | ||||||||
| Practice Location | |||||||||
| Address1: | 909 WALNUT ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159551234 | ||||||||
| FaxNumber: | 2159236792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 6427 | NE | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084A2900X | MD452832 | PA | Y |
No ID Information.