Dougherty, Amy

Dougherty, Amy is an individual health care provider with primary practice located at 8001 Roosevelt Blvd Suite 203, Philadelphia PA 19152-3038. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Dougherty, Amy can be contacted via phone (215) 332-5300.

Contact Information

Primary practice address
8001 Roosevelt Blvd Suite 203 Philadelphia PA 19152-3038
Phone: (215) 332-5300
Fax: (215) 332-5228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 25MD00320000 New Jersey
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X SC006066 Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC006066 Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00320000 New Jersey

Profile Details

NPI number 1184885881
LBN Legal business name Dougherty, Amy
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2008
Last updated Feb 24th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184885881 NPPES
New Jersey MEDICAID 7844107
New Jersey MEDICAID 1030852380001

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