MEDICARE: ANDREW NEASE MACCCSLP

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	235Z00000X	Speech-Language Pathologist	SL009161	PA

General Provider Information

NPI Number	:	1891962593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW NEASE MACCCSLP

Provider Business Mailing Address
First Line	:	635 STAMFORD DR
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6079
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3394 SAXONBURG BLVD
Second Line	:	SUITE 620
City	:	GLENSHAW
State	:	PA
Zip	:	15116-3168
Country	:	US
Telephone Number	:	412-767-5967
Fax Number	:

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

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	01/18/2009

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Directions to “ ANDREW NEASE MACCCSLP” Practice Location

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