Provider Demographics
NPI:1750450433
Name:LESHER, ANDREW J (PT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:LESHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E CITY AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1730
Mailing Address - Country:US
Mailing Address - Phone:610-668-4055
Mailing Address - Fax:610-668-4250
Practice Address - Street 1:225 E CITY AVE
Practice Address - Street 2:STE 250
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1730
Practice Address - Country:US
Practice Address - Phone:610-668-4055
Practice Address - Fax:610-668-4250
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-009218-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA874292OtherHIGHMARK BLUE SHIELD
PA0987072000OtherINDEPENDENCE BLUE CROSS
PA874292H2KMedicare ID - Type Unspecified