Provider Demographics
NPI:1225604911
Name:BOZAK, ANDREA CRISTINA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CRISTINA
Last Name:BOZAK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CARIBOU CT
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1457
Mailing Address - Country:US
Mailing Address - Phone:301-919-2453
Mailing Address - Fax:
Practice Address - Street 1:204 CARIBOU CT
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1457
Practice Address - Country:US
Practice Address - Phone:301-919-2453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily