Provider Demographics
NPI:1336770106
Name:WHELAN, AMBER Z (PA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:Z
Last Name:WHELAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:C
Other - Last Name:ZALEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4 INDUSTRIAL WAY W STE 100
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4239
Mailing Address - Country:US
Mailing Address - Phone:732-935-0407
Mailing Address - Fax:
Practice Address - Street 1:4 INDUSTRIAL WAY W STE 100
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4239
Practice Address - Country:US
Practice Address - Phone:732-935-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant