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NPI Code Detail

MEDICARE: ANDRE T TUCKER

MEDICARE: ANDRE T TUCKER
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
1106S00000XBehavior TechnicianRBT-26-51075NJ

General Provider Information

NPI Number : 1881545226
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRE T TUCKER
Provider Business Mailing Address
First Line : 640 FREEDOM BUSINESS CTR DR STE 220
Second Line :
City : KING OF PRUSSIA
State : PA
Zip : 19406-1376
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 BRIGGS RD STE 280
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-4104
Country : US
Telephone Number : 484-965-9966
Fax Number : 484-231-8631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ ANDRE T TUCKER ” Practice Location

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