Provider Demographics
NPI:1811651680
Name:MADDEN, EMILY LAUREN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LAUREN
Last Name:MADDEN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD STE G04
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9466
Mailing Address - Country:US
Mailing Address - Phone:610-378-2117
Mailing Address - Fax:610-378-2674
Practice Address - Street 1:2494 BERNVILLE RD STE G04
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9466
Practice Address - Country:US
Practice Address - Phone:610-378-2117
Practice Address - Fax:610-378-2674
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA063180363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant