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NPI Code Detail

MEDICARE: ANDREA E HERMAN RPA-C

MEDICARE: ANDREA E HERMAN RPA-C
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
1363A00000XPhysician Assistant013370NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710118781
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA E HERMAN RPA-C
Provider Business Mailing Address
First Line : 1 GUTHRIE SQ
Second Line :
City : SAYRE
State : PA
Zip : 18840-1625
Country : US
Telephone Number : 570-888-5858
Fax Number :
Provider Business Practice Location Address
First Line : 1243 PENNSYLVANIA AVE
Second Line :
City : PINE CITY
State : NY
Zip : 14871-9230
Country : US
Telephone Number : 607-734-3929
Fax Number : 607-734-0781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2009
Last Update Date : 09/14/2011

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