Provider Demographics
NPI:1861479487
Name:MOSS, AMY M (PAC)
Entity Type:Individual
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First Name:AMY
Middle Name:M
Last Name:MOSS
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Gender:F
Credentials:PAC
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Mailing Address - Street 1:1011 REED AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2002
Mailing Address - Country:US
Mailing Address - Phone:610-374-4401
Mailing Address - Fax:610-374-7916
Practice Address - Street 1:1011 REED AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2002
Practice Address - Country:US
Practice Address - Phone:610-374-4401
Practice Address - Fax:610-374-7916
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2016-12-05
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Provider Licenses
StateLicense IDTaxonomies
MDC0003000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant