DR. AMANDA THERESA MOON (NPI# 1144541186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144541186 |
| Entity Type | Individual |
| Full Name | DR. AMANDA THERESA MOON |
| Other Name | DR. AMANDA THERESA CAROLFI |
| Credential | M.D. |
| Practice Address |
219 N Broad St 4th Floor Philadelphia PA 19107-1519 |
| Mailing Address |
1601 Cherry St Suite 11511 Philadelphia PA 19102-1320 |
| Practice Telephone | 2157625550 |
| Mailing Telephone | 2152557822 |
| Mailing Fax Number | 2152557825 |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2016-09-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD013064E | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609363746 | Amanda Moon | Social Worker | 3700 Rome Dr, Lafayette, IN 47905-4489 | 2018-04-14 |
| 1013316116 | Amanda Moon | Pharmacist | 1250 N Preston Rd, Prosper, TX 75078-9095 | 2014-08-14 |
| 1013438357 | Amanda Beth Moon | Behavior Technician | 5863 Nw 72nd St, Kansas City, MO 64151-1483 | 2017-06-27 |
| 1487174215 | Amanda Moon | Behavior Technician | 100 Congress Ave Ste 2000, Austin, TX 78701-2745 | 2017-06-22 |
| 1982156774 | Amanda Moon | Specialist/Technologist | 3510 N Highway 17, Suite 220, Mt Pleasant, SC 29466-8227 | 2016-10-27 |
| 1598110595 | Amanda Moon | Speech-Language Pathologist | 1 Medical Center Dr, Morgantown, WV 26506 | 2016-04-27 |
| 1124346069 | Amanda Smith Moon | Pharmacist | 916 Loganville Hwy, Suite 400, Bethlehem, GA 30620-2144 | 2010-05-16 |
| Street Address |
219 N BROAD ST 4TH FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-1519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457356917 | Jeffrey Brian Hoag | Internal Medicine | 219 N Broad St, 9th Floor, Philadelphia, PA 19107-1519 | 2005-06-20 |
| 1346872116 | Tower Drexel Academic Medical Group LLC | Family Medicine | 219 N Broad St, 8th Fl, Philadelphia, PA 19107-1519 | 2020-02-10 |
| 1629638374 | Osama Mufti | Ophthalmology | 219 N Broad St, Philadelphia, PA 19107-1519 | 2019-06-15 |
| 1538510730 | Emily Gnatt | Audiologist | 219 N Broad St, 10th Floor, Philadelphia, PA 19107-1519 | 2016-06-29 |
| 1295100493 | Jessica Cerasoli | Physician Assistant | 219 N Broad St, Philadelphia, PA 19107-1519 | 2015-12-14 |
| 1992129522 | Zachari Breeding | Dietitian, Registered | 219 N Broad St, 9th Floor, Philadelphia, PA 19107-1519 | 2014-02-18 |
| 1588915649 | Danielle Elizabeth Brown | Physician Assistant | 219 N Broad St, 7th Floor, Philadelphia, PA 19107-1519 | 2012-09-28 |
| 1487918611 | Andrew Ow | Family Medicine | 219 N Broad St, 1st Floor, Philadelphia, PA 19107-1519 | 2012-07-03 |
| 1396006508 | Jing Xing Zhang | Dermatology | 219 N Broad St, 4th Floor, Philadelphia, PA 19107-1519 | 2012-06-04 |
| 1114286614 | Kelly Anne Williamson | Ophthalmology | 219 N Broad St, 3rd Floor, Philadelphia, PA 19107-1519 | 2012-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932740461 | Mark Abdelmalek, Md LLC | Dermatology | 200 N 16th St Ste D, Philadelphia, PA 19102-1225 | 2019-10-07 |
| 1083061048 | Brandon Rowe | Dermatology | 1316 W Ontario St Fl 1, Philadelphia, PA 19140-5220 | 2016-05-19 |
| 1942647078 | Jason Marc Schoenfeld | Dermatology | 9501 Roosevelt Blvd Ste 506, Philadelphia, PA 19114-1030 | 2013-05-30 |
| 1588890669 | Philippe Lafaille | Dermatology | 1200 Locust Street, Philadelphia, PA 19107 | 2009-06-03 |
| 1194950683 | Jisun Cha | Dermatology | 833 Chestnut St Ste 740, Philadelphia, PA 19107-4409 | 2009-05-27 |
| 1962546952 | Susan C. Taylor | Dermatology | 932 Pine St, Philadelphia, PA 19107-6128 | 2007-02-16 |
| 1194833590 | Harold Farber | Dermatology | 9892 Bustleton Avenue, Ste 204 Moss Plaza, Philadelphia, PA 19115 | 2006-08-26 |
| 1770599839 | Seana Patrice Covello | Dermatology | 621 Pine St, Philadelphia, PA 19106-4108 | 2006-07-31 |
| 1528080512 | Kenneth E Wasserman Md PC | Dermatology | 1817 South Broad St, Philadelphia, PA 19148-2115 | 2006-07-25 |
| 1811947351 | James R Treat | Dermatology | 3550 Market St Fl 2, Children's Hospital of Philadelphia - Dermatology Div, Philadelphia, PA 19104-3366 | 2006-05-12 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.