Provider Demographics
NPI:1851392070
Name:LUBELL, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:LUBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:270 COMMERCE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2405
Mailing Address - Country:US
Mailing Address - Phone:215-653-0600
Mailing Address - Fax:215-646-4422
Practice Address - Street 1:270 COMMERCE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2405
Practice Address - Country:US
Practice Address - Phone:215-653-0600
Practice Address - Fax:215-646-4422
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD062453L2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD062443LOtherMEDICAL LICENSE
PA01707819Medicaid
PWBL5881304OtherDEA
PAG75627Medicare UPIN