Provider Demographics
NPI:1033724851
Name:AMANDA SEDGEWICK, PLLC
Entity Type:Organization
Organization Name:AMANDA SEDGEWICK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDGEWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-747-9581
Mailing Address - Street 1:2 APPLE TREE CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5415
Mailing Address - Country:US
Mailing Address - Phone:207-747-9581
Mailing Address - Fax:
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-826-9792
Practice Address - Fax:617-829-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health