Provider Demographics
NPI:1437190097
Name:WHITE, ANDREA MARIE (OT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5228
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0405
Mailing Address - Country:US
Mailing Address - Phone:610-359-5671
Mailing Address - Fax:610-359-1519
Practice Address - Street 1:501 W. MACDADE BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-3224
Practice Address - Country:US
Practice Address - Phone:610-586-7000
Practice Address - Fax:610-586-7004
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002919L225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP84904Medicare UPIN
PW068222NU9Medicare ID - Type Unspecified