Provider Demographics
NPI:1780203695
Name:D'AMICO, MARIA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JEAN
Last Name:D'AMICO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:DEPARTMENT OF UROLOGY THOMAS JEFFERSON UNIVERSITY
Mailing Address - Street 2:1025 WALNUT STREET, SUITE 1100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-955-1416
Mailing Address - Fax:215-923-1884
Practice Address - Street 1:833 CHESTNUT ST STE 703
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4409
Practice Address - Country:US
Practice Address - Phone:215-955-1000
Practice Address - Fax:215-503-2066
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2020-07-21
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Provider Licenses
StateLicense IDTaxonomies
PAMT220661208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology