Provider Demographics
NPI:1225224298
Name:DELMONTE, ANDREA (DC, MSA)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:DELMONTE
Suffix:
Gender:F
Credentials:DC, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-6248
Mailing Address - Country:US
Mailing Address - Phone:267-281-4231
Mailing Address - Fax:267-330-0999
Practice Address - Street 1:1601 WALNUT STREET
Practice Address - Street 2:SUITE 809
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2905
Practice Address - Country:US
Practice Address - Phone:267-281-4231
Practice Address - Fax:267-330-0999
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010070111N00000X
NJ38MC00676800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA164513ZEQPMedicare UPIN