Provider Demographics
NPI:1417597113
Name:ANDRASCIK, VALERIE JUNE (PTA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JUNE
Last Name:ANDRASCIK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 LAWRENCE STREET
Mailing Address - Street 2:OUTPATIENT DEPARTMENT
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:518-691-1454
Mailing Address - Fax:
Practice Address - Street 1:WESLEY HEALTH CARE CENTER, INC
Practice Address - Street 2:131 LAWRENCE STREET
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-691-1454
Practice Address - Fax:518-691-1460
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1614189900225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant