Provider Demographics
NPI:1235236407
Name:PRATS, ANDREA (DO)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PRATS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5317
Practice Address - Country:US
Practice Address - Phone:717-782-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-010107-L207R00000X
PAOS010107L208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001494127OtherHIGHMARK BLUE SHIELD
PA187028OtherUNISON
PA7461770OtherAETNA
PA1015900850001Medicaid
PA50058232OtherBLUE CROSS/ CAIC
PAP00347583OtherRAIL ROAD MEDICARE
PA071643D99Medicare PIN
PA001494127OtherHIGHMARK BLUE SHIELD