Provider Demographics
NPI:1891911137
Name:DELLIGATTI, ANDREA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:M
Last Name:DELLIGATTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HILLBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1111
Mailing Address - Country:US
Mailing Address - Phone:610-647-1013
Mailing Address - Fax:610-640-9941
Practice Address - Street 1:27 HILLBROOK CIR
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1111
Practice Address - Country:US
Practice Address - Phone:610-647-1013
Practice Address - Fax:610-640-9941
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004573L103T00000X
NJ35SI00196000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA567437Medicare PIN