Provider Demographics
NPI:1942265251
Name:WEBER, AMANDA E (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:E
Last Name:WEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 DANIEL WEBSTER HWY
Mailing Address - Street 2:UNIT 11
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220-3053
Mailing Address - Country:US
Mailing Address - Phone:603-524-3397
Mailing Address - Fax:603-524-9364
Practice Address - Street 1:20 COMMERCE PARK N
Practice Address - Street 2:SUITE 103
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6911
Practice Address - Country:US
Practice Address - Phone:603-472-5546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2232225100000X
MA11964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH7793528OtherAETNA--INDIVIDUAL ID#
NH3078250Medicaid
NH7862579OtherCIGNA GROUP ID ONLY
NH08Y003965NH03OtherANTHEM INDIVIDUAL #
NH08Y003965NH03OtherANTHEM INDIVIDUAL #
NHVX3652Medicare PIN