Andrea Louise Didisheim, PTA

Primary specialty

SpecialistTaxonomy code 174400000X

License

PTA40QB00235800 Issued in NJ

Practice address

11 State Rd
Suite 400
Princeton, NJ 08540-1300

Phone

(609) 454-3536

NPI assigned

Sep 8, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Progression Physical Therapy of Princeton

  • Physical Therapy Clinic/Center
  • Princeton, NJ
  • NPI 1598084972
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1093096679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STATE RD",
            "address_2": "SUITE 400",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401300",
            "telephone_number": "609-454-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 STATE RD",
            "address_2": "SUITE 400",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401300",
            "telephone_number": "609-454-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDISHEIM",
        "first_name": "ANDREA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "PTA40QB00235800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Jan Deutsch, M.D.
• Roberta Shakun Devery, MS, OTR
• Maria I Deveza-Siochi, PT
• Dialysis Clinic Inc.
• Stephanie Dicandia, MA, LPC, NCC
• Digestive Disease Center, PA
• Suzy Lyn Diiorio, MS/CCC-SLP
• Deborah Dimeglio-Unfried, OD
• Megan Dinh, MD
• Dakota Dione, PT, DPT

• Specialist in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.