Basic Information
| Provider Information | |||||||||
| NPI: | 1124741046 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAHL | ||||||||
| FirstName: | AMY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8363 HATCH HOLLOW RD | ||||||||
| Address2: | |||||||||
| City: | UNION CITY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164389046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149641397 | ||||||||
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| Practice Location | |||||||||
| Address1: | 315 YORK ST | ||||||||
| Address2: | |||||||||
| City: | CORRY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164071412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146648686 | ||||||||
| FaxNumber: | 8146649826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2022 | ||||||||
| LastUpdateDate: | 11/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | RN626746 | PA | N | Nursing Service Providers | Registered Nurse | General Practice | 163WG0000X | SP026346 | PA | Y | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.