Provider Demographics
NPI:1093989782
Name:DEEDS, ANDREA E (PA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:E
Last Name:DEEDS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:E
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1211 ELM ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19604-2927
Mailing Address - Country:US
Mailing Address - Phone:610-371-7700
Mailing Address - Fax:610-371-9189
Practice Address - Street 1:1211 ELM ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604-2927
Practice Address - Country:US
Practice Address - Phone:610-371-7700
Practice Address - Fax:610-371-9189
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052609363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant