Provider Demographics
NPI:1841218096
Name:DANDREA, JASON JOSEPH (MPT, CERT MDT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:JOSEPH
Last Name:DANDREA
Suffix:
Gender:M
Credentials:MPT, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1672
Mailing Address - Country:US
Mailing Address - Phone:610-518-9100
Mailing Address - Fax:610-518-0992
Practice Address - Street 1:20 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3058
Practice Address - Country:US
Practice Address - Phone:610-518-9100
Practice Address - Fax:610-518-0992
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015742225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic