Provider Demographics
NPI:1891264438
Name:PALENO, ANDREW ROBERT (PA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:PALENO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 STONEWOOD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8326
Mailing Address - Country:US
Mailing Address - Phone:878-884-5473
Mailing Address - Fax:724-242-8672
Practice Address - Street 1:7000 STONEWOOD DR STE 300
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8326
Practice Address - Country:US
Practice Address - Phone:878-884-5473
Practice Address - Fax:724-242-8672
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA191394363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant