Healthcare Provider Details

I. General information

NPI: 1902764863
Provider Name (Legal Business Name): AMANDA SCELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3594 WHITNEY AVE
HAMDEN CT
06518-1560
US

IV. Provider business mailing address

3594 WHITNEY AVE
HAMDEN CT
06518-1560
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-2550
  • Fax: 203-281-7714
Mailing address:
  • Phone: 203-288-2550
  • Fax: 203-281-7714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15575
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: