Basic Information
| Provider Information | |||||||||
| NPI: | 1326239443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DABNEY | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 820933 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159269010 | ||||||||
| FaxNumber: | 2152268285 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E LEHIGH AVE | ||||||||
| Address2: | TEMPLE HOSPITAL EPISCOPAL CAMPUS | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191251012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157071656 | ||||||||
| FaxNumber: | 2157070794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 10/06/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA051618 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.