Basic Information
| Provider Information | |||||||||
| NPI: | 1285176784 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MADARAS | ||||||||
| FirstName: | AMELIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 INDIAN LN | ||||||||
| Address2: | |||||||||
| City: | BOYERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 195128644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4843667203 | ||||||||
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| Practice Location | |||||||||
| Address1: | 925 CHESTNUT STREET 5TH FLOOR | ||||||||
| Address2: | ROTHMAN INSTITUTE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107553098 | ||||||||
| FaxNumber: | 6104951587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2016 | ||||||||
| LastUpdateDate: | 11/15/2016 | ||||||||
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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 | 163WR0006X | RN574409 | PA | Y | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.