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General NPI Number Information
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NPI Number | 1154288942
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Entity Type | Individual
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Provider Name | AMANDA RUCCI
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Gender | Female
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 129 MILITARY RD
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City | GREENBUSH
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State | ME
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Zip | 04418-3137
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Country | US
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Telephone | 207-826-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 30 BISHOP DR
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City | HERMON
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State | ME
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Zip | 04401-0456
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Country | US
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Telephone | 207-217-8812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PA4719
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License Number State | ME
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