SUSAN ANDREA NP NPI 1902966039

NPI Information

NPI: 1902966039
Provider Name: SUSAN ANDREA, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
111 TORREY ST
SUITE A
BROCKTON, MA
ZIP 02301
Phone: (508) 588-1200
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Susan Andrea, NP is a family nurse practitioner in Brockton, MA. Susan Andrea, NP NPI is 1902966039. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

111 TORREY ST
SUITE A
BROCKTON, MA
ZIP 02301-800
Phone: (508) 588-1200
Fax: (508) 941-0497

The NPI 1902966039 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 11/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	149570	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	NP3043	MEDICARE PIN	MASSACHUSETTS
2	P24167	MEDICARE UPIN	MASSACHUSETTS
3	0712604	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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