Provider Demographics
NPI:1689991697
Name:WORLEY, ANDREA DENISE (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DENISE
Last Name:WORLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:DENISE
Other - Last Name:RETTGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2169 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-9405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 CENTER WAY
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2255
Practice Address - Country:US
Practice Address - Phone:607-973-8022
Practice Address - Fax:607-937-1842
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072560A208000000X
NY280903208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics