MEDICARE: DR. ANDREA FANELLI-NOLA PSY.D.

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	103TC0700X	Clinical Psychologist	PS016371	PA

General Provider Information

NPI Number	:	1750552659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA FANELLI-NOLA PSY.D.

Provider Business Mailing Address
First Line	:	33 S DELAWARE AVE
Second Line	:	RIVERVIEW PLAZA, SUITE 106B
City	:	YARDLEY
State	:	PA
Zip	:	19067-1524
Country	:	US
Telephone Number	:	215-595-5834
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 S DELAWARE AVE
Second Line	:	RIVERVIEW PLAZA, SUITE 106B
City	:	YARDLEY
State	:	PA
Zip	:	19067-1524
Country	:	US
Telephone Number	:	215-595-5834
Fax Number	:

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

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	02/04/2016

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