Individual
DR. ANDREA D PEDANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5458 RIDGE AVE, PHILADELPHIA, PA 19128-3732
(215) 487-1887
(215) 487-1818
Mailing address
5458 RIDGE AVE, PHILADELPHIA, PA 19128-3732
(215) 487-1887
(215) 487-1818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008075L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001494970
—
PA
01
—
0808997
AETNA
PA
01
—
1050839
KEYSTONE MERCY
PA
01
—
1159711009
CIGNA
PA
01
—
1464
ELDERHEALTH
PA
01
—
2290076001
KEYSTONE
PA
01
—
40481
AETNA- USHC
PA
01
—
500763
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
05/11/2006
Last updated
07/08/2007
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