Provider Demographics
NPI:1902835580
Name:QUAKERTOWN FAMILY MEDICAL CENTER
Entity type:Organization
Organization Name:QUAKERTOWN FAMILY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CIRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AMENTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-536-2887
Mailing Address - Street 1:920 LAWN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1560
Mailing Address - Country:US
Mailing Address - Phone:267-347-4747
Mailing Address - Fax:267-347-1157
Practice Address - Street 1:1548 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1001
Practice Address - Country:US
Practice Address - Phone:267-347-4747
Practice Address - Fax:267-347-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008831L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
096108Medicare ID - Type Unspecified
G40774Medicare UPIN