Provider Demographics
NPI:1700144904
Name:ONDEYKA, AMY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:ONDEYKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W WASHINGTON SQ
Mailing Address - Street 2:APT 1509
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3513
Mailing Address - Country:US
Mailing Address - Phone:908-591-3694
Mailing Address - Fax:
Practice Address - Street 1:200 ROWAN BLVD
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2260
Practice Address - Country:US
Practice Address - Phone:856-582-1500
Practice Address - Fax:856-218-9607
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09450400207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program