Provider Demographics
NPI:1063748192
Name:CHAPMAN, ANDREA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-4409
Mailing Address - Country:US
Mailing Address - Phone:607-785-0400
Mailing Address - Fax:607-785-0077
Practice Address - Street 1:94 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-4409
Practice Address - Country:US
Practice Address - Phone:607-785-0400
Practice Address - Fax:607-785-0077
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical