Provider Demographics
NPI:1316597628
Name:TERRY, SAMANTHA NICOLE (PA)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:NICOLE
Last Name:TERRY
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Gender:F
Credentials:PA
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Mailing Address - Street 1:ORTHOPAEDIC ASSOCIATES OF READING
Mailing Address - Street 2:850 KNITTING MILLS WAY
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3010
Mailing Address - Country:US
Mailing Address - Phone:610-376-8671
Mailing Address - Fax:610-376-6387
Practice Address - Street 1:ORTHOPAEDIC ASSOCIATES OF READING
Practice Address - Street 2:850 KNITTING MILLS WAY
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3010
Practice Address - Country:US
Practice Address - Phone:610-376-8671
Practice Address - Fax:610-376-6387
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2022-03-22
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Provider Licenses
StateLicense IDTaxonomies
PAOA005011363A00000X
PAMA061047363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant