Healthcare Provider Details

I. General information

NPI: 1821443193
Provider Name (Legal Business Name): AMANDA O'MEARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST STE 525
HARTFORD CT
06106-5525
US

IV. Provider business mailing address

UCONN HEALTH 263 FARMINGTON AVE
FARMINGTON CT
06030-2947
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-4338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number65163
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number65163
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: