Provider Demographics
NPI:1376515445
Name:MOSCHITTA, ANDREW M (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:MOSCHITTA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 ROCK RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1464
Mailing Address - Country:US
Mailing Address - Phone:610-269-7364
Mailing Address - Fax:
Practice Address - Street 1:160 N GULPH RD
Practice Address - Street 2:SEARS BLDG
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2937
Practice Address - Country:US
Practice Address - Phone:610-337-0805
Practice Address - Fax:610-337-0804
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET 008962152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA541571Medicare ID - Type Unspecified
PAU17576Medicare UPIN