Healthcare Provider Details

I. General information

NPI: 1376365759
Provider Name (Legal Business Name): AMANDA L SIGAFOOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CENTRE DR STE 102
MONROE TWP NJ
08831-1501
US

IV. Provider business mailing address

32 IVINS DR
NEW EGYPT NJ
08533-2807
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-3551
  • Fax:
Mailing address:
  • Phone: 732-865-0105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: