Provider Demographics
NPI:1235621996
Name:RICARD, AMANDA KATE (DO)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:KATE
Last Name:RICARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KATE
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2404 BETHLEHEM FIELDS WAY
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-9529
Mailing Address - Country:US
Mailing Address - Phone:610-780-8183
Mailing Address - Fax:
Practice Address - Street 1:1665 VALLEY CENTER PKWY STE 130
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2352
Practice Address - Country:US
Practice Address - Phone:610-317-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT018411207V00000X
PAOS022324207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology