MEDICARE: ANDREA M ELINICH MSACN, LMT

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	225700000X	Massage Therapist	MSG12601	PA
2	133N00000X	Nutritionist
3	173C00000X	Reflexologist

General Provider Information

NPI Number	:	1932074283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA M ELINICH MSACN, LMT

Provider Business Mailing Address
First Line	:	707 PINE ST
Second Line	:
City	:	BARTO
State	:	PA
Zip	:	19504-9545
Country	:	US
Telephone Number	:	484-697-9304
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 PINE ST
Second Line	:
City	:	BARTO
State	:	PA
Zip	:	19504-9545
Country	:	US
Telephone Number	:	484-697-9304
Fax Number	:

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

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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