Provider Demographics
NPI:1376521062
Name:MECCA, ANDREW L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:MECCA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2315 MYRTLE STREET
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4604
Mailing Address - Country:US
Mailing Address - Phone:814-453-7767
Mailing Address - Fax:814-454-6667
Practice Address - Street 1:2315 MYRTLE STREET
Practice Address - Street 2:SUITE 190
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4604
Practice Address - Country:US
Practice Address - Phone:814-453-7767
Practice Address - Fax:814-454-6667
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2020-09-29
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Provider Licenses
StateLicense IDTaxonomies
PAMD064649L207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017188770003Medicaid
PAG64472Medicare UPIN
PA0017188770003Medicaid
PA006656Medicare ID - Type Unspecified