Provider Demographics
NPI:1053560417
Name:ZWISLEWSKI, AMY (MA, FAAA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ZWISLEWSKI
Suffix:
Gender:F
Credentials:MA, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6303
Mailing Address - Country:US
Mailing Address - Phone:215-362-1817
Mailing Address - Fax:
Practice Address - Street 1:8350 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2531
Practice Address - Country:US
Practice Address - Phone:215-331-6878
Practice Address - Fax:215-331-4152
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000949L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist