MEDICARE: MR. JAMES JOSEPH ANDRASSY PA-C

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	363AM0700X	Medical Physician Assistant	50.000343	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50.000343	OTHER	OH	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1962533448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES JOSEPH ANDRASSY PA-C

Provider Business Mailing Address
First Line	:	3700 PARK EAST DR
Second Line	:	STE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4339
Country	:	US
Telephone Number	:	216-593-7180
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 PARK EAST DR
Second Line	:	STE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4339
Country	:	US
Telephone Number	:	216-593-7180
Fax Number	:

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	06/06/2016

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