Provider Demographics
NPI:1104304039
Name:LIVINGSTON, ANDREW JAMES (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:JAMES
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 GREENSPRING DR
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3114
Mailing Address - Country:US
Mailing Address - Phone:410-989-3833
Mailing Address - Fax:
Practice Address - Street 1:10 N HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3650
Practice Address - Country:US
Practice Address - Phone:410-989-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027040225100000X
MD27551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist