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General NPI Number Information
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NPI Number | 1184066433
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Entity Type | Individual
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Provider Name | PHILIPPE DIDIER ANDRE PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 426 CALEF HWY
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City | BARRINGTON
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State | NH
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Zip | 03825-7235
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Country | US
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Telephone | 603-664-9003
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Fax | 603-664-0133
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Provider Business Mailing Address
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Address Line | 931 W OAK ST STE 103
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City | KISSIMMEE
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State | FL
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Zip | 34741-4973
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Country | US
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Telephone | 407-931-0444
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Fax | 407-962-4446
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9107293
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1787
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License Number State | NH
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