Healthcare Provider Details

I. General information

NPI: 1669257572
Provider Name (Legal Business Name): ELIZABETH LING SCAMMELL AMADEI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 S SCHUMAKER DR
SALISBURY MD
21804-9237
US

IV. Provider business mailing address

19 CORNERSTONE DR
FALMOUTH ME
04105-2611
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-2848
  • Fax:
Mailing address:
  • Phone: 207-776-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA5871
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: