Amanda C Edison
Physician Assistant, Surgical in South Glastonbury, Connecticut
1518623321- Practice location
- 157 Stockade RD, South Glastonbury, CT 06073-2118
- Phone
- 860-331-0060
- Fax
- —
- Last updated
- February 23, 2022
Amanda Catherine Edison is a Physician Assistant, Surgical based in South Glastonbury, CT. Amanda Catherine Edison practices in South Glastonbury, CT. The NPI Number for Amanda Catherine Edison is 1518623321 and holds a License No. 5583 (CT). The current practice location address for Amanda Catherine Edison is 157 Stockade RD, South Glastonbury, CT 06073-2118 and can be reached out via phone at 860-331-0060.
Provider Profile Details
- NPI Number
- 1518623321
- Provider Name
- Amanda Catherine Edison
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 157 Stockade RD, South Glastonbury, CT 06073-2118
- Phone Number
- 860-331-0060
- Primary Taxonomy
- Physician Assistant, Surgical · 363AS0400X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- November 16, 2021
- Last Update Date
- February 23, 2022
- Certification Date
- February 23, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 157 Stockade RD
South Glastonbury, CT 06073-2118 - State
- Connecticut
- Zip
- 06073-2118
- Phone Number
- 860-331-0060
Provider Business Mailing Address Details
- Address
- 157 Stockade RD
South Glastonbury, CT 06073-2118 - City
- South Glastonbury
- State
- CT
- Zip
- 06073-2118
- Phone Number
- 860-331-0060
License Information
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (2)
- 5583
- License State (2)
- CT
- Taxonomy (2)
- Physician Assistant, Surgical · 363AS0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Amanda C Edison?
The NPI number of Amanda C Edison is 1518623321. It was assigned on November 16, 2021 and is currently active in the NPPES registry.
What is the specialty of Amanda C Edison?
Amanda C Edison is registered under the primary taxonomy Physician Assistant, Surgical (code 363AS0400X), licensed in CT under license number 5583.
Where does Amanda C Edison practice?
The practice location is 157 Stockade RD, South Glastonbury, CT 06073-2118. The office can be reached at 860-331-0060 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1518623321 directly on the NPPES registry website.