Provider Demographics
NPI:1922157346
Name:FELDMAN, ANDREA E (PA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:E
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HENDERSON ROAD
Mailing Address - Street 2:SUITE 308C
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406
Mailing Address - Country:US
Mailing Address - Phone:610-337-3111
Mailing Address - Fax:610-337-3506
Practice Address - Street 1:700 S HENDERSON ROAD
Practice Address - Street 2:SUITE 308C
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406
Practice Address - Country:US
Practice Address - Phone:610-337-3111
Practice Address - Fax:610-337-3506
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002549L208100000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
P52072Medicare UPIN
PA055453Medicare ID - Type Unspecified