Provider Demographics
NPI:1952371833
Name:SWAIN, AMANDA JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JANE
Last Name:SWAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:JANE
Other - Last Name:FINEGOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6006 MUSKET RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1810
Mailing Address - Country:US
Mailing Address - Phone:215-805-3568
Mailing Address - Fax:215-746-1032
Practice Address - Street 1:3535 MARKET ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3309
Practice Address - Country:US
Practice Address - Phone:215-746-1005
Practice Address - Fax:215-746-1032
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07907800207Q00000X
PAMD426867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0071552Medicaid
NJI30534Medicare UPIN
NJ0071552Medicaid