Provider Demographics
NPI:1801835616
Name:DELANEY, ANDREW J (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:DELANEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-0636
Mailing Address - Country:US
Mailing Address - Phone:610-779-2020
Mailing Address - Fax:
Practice Address - Street 1:3326 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-8136
Practice Address - Country:US
Practice Address - Phone:610-779-2020
Practice Address - Fax:610-404-1011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000263152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADE436855OtherHIGHMARK
410007084OtherRAILROAD MEDICARE
PA02717600OtherCAPITAL BLUE CROSS
PA0577000001Medicare NSC
PADE436855OtherHIGHMARK
PAT30431Medicare UPIN