Provider Demographics
NPI:1841202660
Name:LOVE, AMY G (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:G
Last Name:LOVE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:435 MEDFORD LEAS
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2210
Mailing Address - Country:US
Mailing Address - Phone:609-367-4929
Mailing Address - Fax:855-329-1309
Practice Address - Street 1:435 MEDFORD LEAS
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2210
Practice Address - Country:US
Practice Address - Phone:609-367-4929
Practice Address - Fax:855-329-1309
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA 633712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF672264Medicare UPIN
NJM0000781Medicare ID - Type Unspecified