Provider Demographics
NPI:1235593203
Name:KWOK, ANDREA NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:KWOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 REISTERSTOWN RD
Mailing Address - Street 2:STE 130
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1306
Mailing Address - Country:US
Mailing Address - Phone:410-415-5905
Mailing Address - Fax:410-415-5906
Practice Address - Street 1:1777 REISTERSTOWN RD
Practice Address - Street 2:STE 130
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1306
Practice Address - Country:US
Practice Address - Phone:410-415-5905
Practice Address - Fax:410-415-5906
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist