Provider Demographics
NPI:1285445759
Name:CONGENI, ANDREW NICHOLAS
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:NICHOLAS
Last Name:CONGENI
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:NICHOLAS
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2133 HALSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-6210
Mailing Address - Country:US
Mailing Address - Phone:216-224-0932
Mailing Address - Fax:
Practice Address - Street 1:2115 ROBIN ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-5223
Practice Address - Country:US
Practice Address - Phone:216-224-0932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide