Individual
DR. ROBERT A ANDREOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
845 NORMAN DR, LEBANON, PA 17042-7445
(717) 273-8091
(717) 273-9081
Mailing address
845 NORMAN DR, LEBANON, PA 17042-7445
(717) 273-8091
(717) 273-9081
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD123456E
PA
207NS0135X
Procedural Dermatology Physician
MD014933E
PA
207ZD0900X
Dermatopathology (Pathology) Physician
MD014933E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006094390001
—
PA
01
—
01694001
CAP BC IND PROVIDER NUMBE
PA
01
—
1520325
GATEWAY INS PROVIDER #
PA
01
—
178115
BS IND PROVIDER NUMBER
PA
01
—
178115HE5
PTAN
PA
Enumeration date
07/13/2005
Last updated
10/10/2014
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