Provider Demographics
NPI:1225354202
Name:YESVETZ, AMANDA BETH (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:YESVETZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BETH
Other - Last Name:BITTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5325 NORTHGATE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9416
Mailing Address - Country:US
Mailing Address - Phone:610-954-9400
Mailing Address - Fax:610-954-0333
Practice Address - Street 1:5325 NORTHGATE DR STE 209
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9416
Practice Address - Country:US
Practice Address - Phone:610-954-9400
Practice Address - Fax:610-954-0333
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054132363AM0700X
PAOA002445363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50092856OtherCAPITAL BLUE CROSS
PA50092856OtherCAPITAL BLUE CROSS