Provider Demographics
NPI:1760808281
Name:CONWAY, ANDREA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:CIANCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:555 TURNPIKE ST STE 52
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5935
Mailing Address - Country:US
Mailing Address - Phone:978-687-1151
Mailing Address - Fax:
Practice Address - Street 1:555 TURNPIKE ST STE 52
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5935
Practice Address - Country:US
Practice Address - Phone:978-687-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant