Provider Demographics
NPI:1770885055
Name:VAN AS, ANDRE W W
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:W W
Last Name:VAN AS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 ROBYNWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5746
Mailing Address - Country:US
Mailing Address - Phone:610-429-1289
Mailing Address - Fax:
Practice Address - Street 1:1273 ROBYNWOOD LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5746
Practice Address - Country:US
Practice Address - Phone:610-429-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM80-104207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease