MEDICARE: ANDREA MARIE WHITE OT

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	225XH1200X	Hand Occupational Therapist	OC002919L	PA

General Provider Information

NPI Number	:	1437190097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE WHITE OT

Provider Business Mailing Address
First Line	:	PO BOX 5228
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-0405
Country	:	US
Telephone Number	:	610-359-5671
Fax Number	:	610-359-1519

Provider Business Practice Location Address
First Line	:	501 W. MACDADE BLVD
Second Line	:	2ND FLOOR
City	:	FOLSOM
State	:	PA
Zip	:	19033-3224
Country	:	US
Telephone Number	:	610-586-7000
Fax Number	:	610-586-7004

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	11/14/2023

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