Provider Demographics
NPI:1083316756
Name:AMENDOLARA, ALFRED BIAGIO JR (DO)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:BIAGIO
Last Name:AMENDOLARA
Suffix:JR
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-5302
Mailing Address - Country:US
Mailing Address - Phone:484-526-5210
Mailing Address - Fax:866-568-6561
Practice Address - Street 1:2403 BUTLER ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-5302
Practice Address - Country:US
Practice Address - Phone:484-526-5210
Practice Address - Fax:866-568-6561
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT0242622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology