MEDICARE: ANDREW D DAYNEKA MD

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	207Q00000X	Family Medicine Physician	35077465D	OH
2	207Q00000X	Family Medicine Physician	MD453611	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780798892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW D DAYNEKA MD

Provider Business Mailing Address
First Line	:	2422 S. BROAD STREET
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-4418
Country	:	US
Telephone Number	:	215-952-9100
Fax Number	:	215-463-3125

Provider Business Practice Location Address
First Line	:	700 WALNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3505
Country	:	US
Telephone Number	:	215-955-1730
Fax Number	:	215-955-8592

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	12/19/2018

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