Provider Demographics
NPI:1164655502
Name:BERTORELLI, ANDREA C (CPNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:C
Last Name:BERTORELLI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 BOSTON POST RD
Mailing Address - Street 2:MILLBROOK PEDIATRICS, SUITE 2002
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776
Mailing Address - Country:US
Mailing Address - Phone:978-443-0707
Mailing Address - Fax:
Practice Address - Street 1:490 BOSTON POST RD
Practice Address - Street 2:SUITE 2002
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776
Practice Address - Country:US
Practice Address - Phone:978-443-0707
Practice Address - Fax:978-440-9389
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263463363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner