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General NPI Number Information
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NPI Number | 1609034875
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Entity Type | Individual
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Provider Name | TECILE TRAKESHIA PRINCE ANDOLINO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 5425 LANARK RD
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City | CENTER VALLEY
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State | PA
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Zip | 18034-8697
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Country | US
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Telephone | 484-658-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 LANARK RD
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City | CENTER VALLEY
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State | PA
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Zip | 18034-8697
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Country | US
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Telephone | 484-658-5437
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01068479
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | MD452604
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License Number State | PA
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