MS. AMANDA HOLLERAN (NPI# 1417375981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417375981 |
Entity Type | Individual |
Full Name | MS. AMANDA HOLLERAN |
Other Name | AMANDA MOYER |
Credential | M.D. |
Practice Address |
1175 E Mountain Blvd Wilkes Barre PA 18702-7906 |
Mailing Address |
100 N Academy Ave Danville PA 17822-4903 |
Practice Telephone | 5708081093 |
Mailing Telephone | 5702716144 |
Mailing Fax Number | 5702716578 |
Enumeration Date | 2014-04-02 |
Last Update Date | 2020-09-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
MD470840 | PA | Allopathic & Osteopathic Physicians |
N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
BF4323200B29 | VT | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
11 Colchester Ct # 222wp2, Burlington, VT 054011525 | 8028472700 |
Street Address |
1175 E MOUNTAIN BLVD |
City | WILKES BARRE |
State | PA |
Zip Code | 18702-7906 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104812239 | Anthony J Balsamo | Orthopaedic Surgery | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2005-09-23 |
1467060756 | Laura Brady | Physician Assistant | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2020-07-22 |
1558993006 | Christine Ann Myers | Specialist/Technologist | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2020-02-12 |
1528603370 | Tan Chen | Orthopaedic Surgery | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2019-11-14 |
1285276139 | Evonna Ackourey | Orthopaedic Surgery | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2019-10-11 |
1790330876 | Michael Kendra | Physician Assistant | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2019-08-06 |
1770090334 | Kierstin Nicole Hughes | Physician Assistant | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2018-01-04 |
1528573722 | Angela Janine Reese | Physical Therapist | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2017-12-11 |
1780199067 | Pamela Ann Ceol | Physical Therapy Assistant | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2017-12-07 |
1598216822 | Brandon Philip Lombardo | Physician Assistant | 1175 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2016-10-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477153161 | Joann Bonn | Pharmacist | 441 Wilkes-barre Township Blvd, Wilkes-barre, PA 18702 | 2020-10-30 |
1689213167 | Megan Grace Zanghi | Pharmacist | 58-60 Public Square, 4th Floor, Wilkes-barre, PA 18702 | 2019-12-31 |
1467013292 | Kelly Rose Sones | Pharmacist | 58/60 Public Square, Wilkes-barre, PA 18702 | 2019-06-24 |
1528520186 | Adam Olivetti | Pharmacist | 58-60 Public Square, Wilkes-barre, PA 18702 | 2019-04-03 |
1295220648 | Dental Associates of Nepa PC | Dentist | 360 Kidder Street, Suite 5, Wilkes Barre, PA 18702 | 2018-06-28 |
1568983245 | Bio-medical Applications of Pennsylavania, Inc. | Clinic/Center | 309 Laird St, Wilkes-barre, PA 18702 | 2017-07-03 |
1538615166 | Elsa Gates | Nurse Practitioner | 100 East Mountain Blvd, Geisinger, Wilkes Barre, PA 18702 | 2016-09-01 |
1972990455 | Epeople Health Care Inc. | Home Health | 1092 Route 315, Ste 3, Wilkes Barre, PA 18702 | 2015-04-22 |
1063819001 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 277 Mundy St, Suite 101, Wilkes Barre, PA 18702 | 2014-11-19 |
1356764013 | Jill Stacchiotti | Speech-Language Pathologist | 2 Salem Drive, Laflin, PA 18702 | 2014-01-30 |
Find all providers in zip 18702 |
Taxonomy Code | 207XX0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Foot and Ankle Surgery |
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063066959 | Lauren Olivia Buchma | Orthopaedic Surgery | 30 Hope Drive Bldg B Suite 2400, Hershey, PA 17033-2036 | 2019-07-29 |
1154557908 | Orthopaedic Associates of Allentown | Orthopaedic Surgery | 341 E Bertsch St, Lansford, PA 18232-2111 | 2009-06-08 |
1710406103 | Eliezer Sidon | Orthopaedic Surgery | 1015 Chestnut St Ste 801, Philadelphia, PA 19107-4308 | 2017-09-17 |
1821409632 | Alan C Stuto | Orthopaedic Surgery | 1250 S Cedar Crest Blvd Ste 110, Allentown, PA 18103 | 2014-05-14 |
1649535048 | Umur Aydogan | Orthopaedic Surgery | 500 University Dr, Hershey, PA 17033-2360 | 2012-07-11 |
1841553278 | James Robert Lachman | Orthopaedic Surgery | 1534 Park Ave, Quakertown, PA 18951-1084 | 2012-06-20 |
1740507185 | Rachel Shakked | Orthopaedic Surgery | 2400 Maryland Rd, Suite 20, Willow Grove, PA 19090-1700 | 2010-04-26 |
1578790853 | George Chloros | Orthopaedic Surgery | 1307 Federal St Ste 2, Pittsburgh, PA 15212-4769 | 2009-06-15 |
1609012368 | Jennifer H Fortenberry | Orthopaedic Surgery | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2008-12-31 |
1043470586 | Clinical Health Care Associates of New Jersey, PC | Orthopaedic Surgery | 230 W Washington Sq, 5th Floor, Philadelphia, PA 19106-3500 | 2008-06-09 |
Find all providers with the same taxonomy |
City | WILKES BARRE |
Zip Code | 18702 |
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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.