Provider Demographics
NPI:1235597568
Name:CHERRINGTON, ANDREA ALLEN (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ALLEN
Last Name:CHERRINGTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDRE'A
Other - Middle Name:ALLEN
Other - Last Name:CHERRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1040 BUSHWICK AVE
Mailing Address - Street 2:C24
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-4354
Mailing Address - Country:US
Mailing Address - Phone:347-825-0277
Mailing Address - Fax:
Practice Address - Street 1:1040 BUSHWICK AVE
Practice Address - Street 2:C24
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-4354
Practice Address - Country:US
Practice Address - Phone:347-825-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019436363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant