Provider Demographics
NPI:1336264738
Name:TSCHEPPE, ANDREW H (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:TSCHEPPE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SCOVILL ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1107
Mailing Address - Country:US
Mailing Address - Phone:203-757-7246
Mailing Address - Fax:203-757-7247
Practice Address - Street 1:11 SCOVILL ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1107
Practice Address - Country:US
Practice Address - Phone:203-757-7246
Practice Address - Fax:203-757-7247
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350001164Medicare PIN
CTU88486Medicare UPIN