Provider Demographics
NPI:1831522465
Name:KARWECK, ANDREA J (PSYD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:KARWECK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 MADISON MARKETPLACE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-2343
Mailing Address - Country:US
Mailing Address - Phone:315-825-3111
Mailing Address - Fax:315-825-3017
Practice Address - Street 1:1055 MADISON MARKETPLACE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-2343
Practice Address - Country:US
Practice Address - Phone:315-825-3111
Practice Address - Fax:315-825-3017
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000850674OtherBCBS MEMORIAL CHILDRENS HOSPITAL
IN201184450Medicaid
IN201184450Medicaid