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General NPI Number Information
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NPI Number | 1548510167
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Entity Type | Organization
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Legal Business Name | D'ANDREA CARDIOVASCULAR CARE CENTER LLC
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 672 N RIVER ST SUITE 101
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City | PLAINS
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State | PA
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Zip | 18705-1014
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Country | US
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Telephone | 570-814-7996
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Fax |
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Provider Business Mailing Address
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Address Line | 672 N RIVER ST SUITE 101
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City | PLAINS
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State | PA
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Zip | 18705-1014
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY P D'ANDREA
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Credential | DO
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Telephone | 570-814-7996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS008189L
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License Number State | PA
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