Provider Demographics
NPI:1285039644
Name:CAMODECA, AMY (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:CAMODECA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CAMP MEETING RD.
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9999
Mailing Address - Country:US
Mailing Address - Phone:412-741-1800
Mailing Address - Fax:412-741-9021
Practice Address - Street 1:301 CAMP MEETING RD.
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9999
Practice Address - Country:US
Practice Address - Phone:412-741-1800
Practice Address - Fax:412-741-9021
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017700103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist