Provider Demographics
NPI:1245294198
Name:MCANDREWS, BECKY D (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:D
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 WINNEPOGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2543
Mailing Address - Country:US
Mailing Address - Phone:203-292-3924
Mailing Address - Fax:
Practice Address - Street 1:30 STEVENS ST
Practice Address - Street 2:SUITE D
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3859
Practice Address - Country:US
Practice Address - Phone:203-852-2262
Practice Address - Fax:203-855-3878
Is Sole Proprietor?:No
Enumeration Date:2006-04-15
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000586363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical