Provider Demographics
NPI:1962412791
Name:ANDREWS, ALLISON (PAC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 W. 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:BIROSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2118
Mailing Address - Country:US
Mailing Address - Phone:610-858-4779
Mailing Address - Fax:610-792-4026
Practice Address - Street 1:628 W. 2ND STREET
Practice Address - Street 2:
Practice Address - City:BIROSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2118
Practice Address - Country:US
Practice Address - Phone:610-858-4779
Practice Address - Fax:610-792-4026
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000727L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094944Medicare ID - Type Unspecified
PAR06027Medicare UPIN