Amy Larissa Dedea, PHARMD, PA-C is a
Physician Assistant based in Dewey, Arizona. Amy Larissa Dedea is licensed to practice in Connecticut (license number 2405) and her current practice location is
12075 Az-69, Dewey, Arizona. She can be reached at her office (for appointments etc.) via phone at
(928) 772-1673.
NPI number for Amy Larissa Dedea is 1861506370 and her current mailing address is 85 Canyon Trl, Sedona, Arizona. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861506370.
Healthcare Provider's Profile
| Full Name | Amy Larissa Dedea |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 12075 Az-69, Dewey, Arizona |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1861506370
- Provider Enumeration Date: 08/19/2006
- Last Update Date: 09/18/2019
Medical Identifiers
Medical identifiers for Amy Larissa Dedea such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861506370 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | S018219 (Arizona) | Secondary |
| 183500000X | Pharmacist | PS38830 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 2405 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Larissa Dedea is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amy Larissa Dedea, PHARMD, PA-C
85 Canyon Trl,
Sedona, AZ 86351-7705
Ph: (928) 773-2525 | Amy Larissa Dedea, PHARMD, PA-C
12075 Az-69,
Dewey, AZ 86327
Ph: (928) 772-1673 |
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