MEDICARE: MS. AMANDA L SEKUSKY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	OS018549	PA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1295067437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA L SEKUSKY D.O.

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 E MOUNTAIN BLVD
Second Line	:
City	:	BEAR CREEK TOWNSHIP
State	:	PA
Zip	:	18702-7909
Country	:	US
Telephone Number	:	570-808-2383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	04/25/2017

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