Healthcare Provider Details

I. General information

NPI: 1588076715
Provider Name (Legal Business Name): AMANDA SEDGEWICK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA ELIZABETH RAGO

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MARKET PLACE DR STE 1-2
YORK ME
03909-1698
US

IV. Provider business mailing address

115 MILL STREET MAIL STOP #222
BELMONT MA
02478
US

V. Phone/Fax

Practice location:
  • Phone: 207-630-2922
  • Fax: 207-805-7970
Mailing address:
  • Phone: 617-855-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number274736
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDO2666
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: