Provider Demographics
NPI:1669470738
Name:WERTMAN, AMY BETH (PA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:WERTMAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:919 CONESTOGA ROAD
Mailing Address - Street 2:BUILDING ONE SUITE #300
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1352
Mailing Address - Country:US
Mailing Address - Phone:610-525-6580
Mailing Address - Fax:610-525-3664
Practice Address - Street 1:919 CONESTOGA ROAD
Practice Address - Street 2:BUILDING ONE SUITE #300
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:610-525-6580
Practice Address - Fax:610-525-3664
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2011-09-16
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Provider Licenses
StateLicense IDTaxonomies
PAMA003367L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
173054XDKMedicare PIN