MEDICARE: ANDREA BECKER MD

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	207RC0000X	Cardiovascular Disease Physician	MD025193E	PA

General Provider Information

NPI Number	:	1609871615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BECKER MD

Provider Business Mailing Address
First Line	:	1100 HECTOR ST.,
Second Line	:	SUITE 105
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2320
Country	:	US
Telephone Number	:	610-828-2608
Fax Number	:	610-828-0102

Provider Business Practice Location Address
First Line	:	1100 HECTOR ST.,
Second Line	:	SUITE 105
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2320
Country	:	US
Telephone Number	:	610-828-2608
Fax Number	:	610-828-0102

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/25/2015

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