Provider Demographics
NPI:1720269921
Name:DELLACROCE, ANDREA MARIE (CEIS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:DELLACROCE
Suffix:
Gender:F
Credentials:CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2806
Mailing Address - Country:US
Mailing Address - Phone:508-498-6983
Mailing Address - Fax:
Practice Address - Street 1:300 E MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2806
Practice Address - Country:US
Practice Address - Phone:508-498-6983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist