Provider Demographics
NPI:1467816769
Name:CHY, ANDY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:CHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4488 GREAT SMOKEY CIR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7129
Mailing Address - Country:US
Mailing Address - Phone:330-461-4306
Mailing Address - Fax:
Practice Address - Street 1:4488 GREAT SMOKEY CIR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7129
Practice Address - Country:US
Practice Address - Phone:330-461-4306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH386124163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology