Provider Demographics
NPI:1619440831
Name:DAVE, AMAR VIJAY
Entity type:Individual
Prefix:MR
First Name:AMAR
Middle Name:VIJAY
Last Name:DAVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7816 MINE RUN RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2601
Mailing Address - Country:US
Mailing Address - Phone:847-757-2475
Mailing Address - Fax:
Practice Address - Street 1:2615 TULIP ST APT B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1818
Practice Address - Country:US
Practice Address - Phone:847-757-2475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health