Provider Demographics
NPI:1730065079
Name:OBIEDZINSKI, AMANDA OPHELIA (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:OPHELIA
Last Name:OBIEDZINSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1136
Mailing Address - Country:US
Mailing Address - Phone:908-500-8186
Mailing Address - Fax:
Practice Address - Street 1:153 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8931
Practice Address - Country:US
Practice Address - Phone:484-526-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02357100225100000X
PACP048691T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist