MEDICARE: MR. ANDREW S BISHOP OTR/L

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	U1-0001915	DE
2	225X00000X	Occupational Therapist	U1-0001915	DE

General Provider Information

NPI Number	:	1821575861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW S BISHOP OTR/L

Provider Business Mailing Address
First Line	:	101 CHIPMAN DR
Second Line	:
City	:	MAGNOLIA
State	:	DE
Zip	:	19962-4601
Country	:	US
Telephone Number	:	609-970-0839
Fax Number	:

Provider Business Practice Location Address
First Line	:	252 CARTER DR
Second Line	:
City	:	MIDDLETOWN
State	:	DE
Zip	:	19709-5855
Country	:	US
Telephone Number	:	302-655-9494
Fax Number	:	302-691-1478

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

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	09/16/2020

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