Provider Demographics
NPI:1518019280
Name:DEVICO, ANDREA LEA (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEA
Last Name:DEVICO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:LEA
Other - Last Name:DEVICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:930 VIENTO PT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260
Mailing Address - Country:US
Mailing Address - Phone:585-507-2868
Mailing Address - Fax:
Practice Address - Street 1:155 HOOVER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3641
Practice Address - Country:US
Practice Address - Phone:585-461-2275
Practice Address - Fax:585-461-4726
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS