Basic Information
Provider Information
NPI: 1225311798
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HU
FirstName: AMANDA
MiddleName: CHIA-MING
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 219 N BROAD ST FL 10
Address2: PHILADELPHIA EAR NOSE & THROAT ASSOCIATES
City: PHILADELPHIA
State: PA
PostalCode: 191071506
CountryCode: US
TelephoneNumber: 2157625530
FaxNumber: 2157625540
Practice Location
Address1: 219 N BROAD ST FL 10
Address2: PHILADELPHIA EAR NOSE & THROAT ASSOCIATES
City: PHILADELPHIA
State: PA
PostalCode: 191071506
CountryCode: US
TelephoneNumber: 2157625530
FaxNumber: 2157625540
Other Information
ProviderEnumerationDate: 09/21/2011
LastUpdateDate: 09/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XMD 445017PAY Allopathic & Osteopathic PhysiciansOtolaryngology 
207Y00000XMD60164585WAN Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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