Healthcare Provider Details

I. General information

NPI: 1548123300
Provider Name (Legal Business Name): AMANDA HUCKESTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 SAXONY TRL
SAXONBURG PA
16056-2425
US

IV. Provider business mailing address

107 WOODLAND RD
PITTSBURGH PA
15232-2871
US

V. Phone/Fax

Practice location:
  • Phone: 724-831-4188
  • Fax:
Mailing address:
  • Phone: 724-831-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: