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NPI Code Detail

MEDICARE: JESSICA K MCANDREW RN

MEDICARE: JESSICA K MCANDREW RN
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
1163W00000XRegistered Nurse501405NY

General Provider Information

NPI Number : 1598878662
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA K MCANDREW RN
Provider Business Mailing Address
First Line : 5742 APOLLO DR
Second Line :
City : LAKE VIEW
State : NY
Zip : 14085-9636
Country : US
Telephone Number : 716-627-6655
Fax Number :
Provider Business Practice Location Address
First Line : 4635 UNION RD
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-1851
Country : US
Telephone Number : 716-505-5700
Fax Number : 716-633-9351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 07/08/2007

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