Provider Demographics
NPI:1063485308
Name:SITKOFF, ANDREW D (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:SITKOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 LINCOLN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4435
Mailing Address - Country:US
Mailing Address - Phone:610-241-3050
Mailing Address - Fax:610-241-3059
Practice Address - Street 1:839 LINCOLN AVE STE A
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4435
Practice Address - Country:US
Practice Address - Phone:610-241-3050
Practice Address - Fax:610-241-3059
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005998L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01138ZZZMedicaid
2528344OtherAETNA
PA1669514OtherBLUE SHIELD
2346974001OtherKEYSTONE PERS CHOICE HALL
PA1669514OtherBLUE SHIELD
PA01138ZZZMedicaid