Provider Demographics
NPI:1659504942
Name:VENDITTI, ANDREW MICHAEL
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:VENDITTI
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 1:2544 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1110
Mailing Address - Country:US
Mailing Address - Phone:315-446-4136
Mailing Address - Fax:315-701-0899
Practice Address - Street 1:2544 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1110
Practice Address - Country:US
Practice Address - Phone:315-446-4136
Practice Address - Fax:315-701-0899
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies