Active NPI
Andrea Hake, DOM
- Acupuncturist
- Wayne, PA
National Provider Identifier
1104085620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- OM000075
- Practice address
- 175 Strafford Ave Ste 1
Wayne, PA 19087-3340 - Phone
- (610) 772-1740
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 958 | NM | |
| Acupuncturist | 171100000X | OM000075 | PA | Primary |
Addresses
Primary practice location
175 Strafford Ave Ste 1
Wayne, PA 19087-3340
Mailing address
175 Strafford Ave Ste 1
Wayne, PA 19087-3340
Phone (610) 772-1740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 958 | NM | MD | Acupuncturist |
| OM000075 | PA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1104085620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 STRAFFORD AVE STE 1",
"city": "WAYNE",
"state": "PA",
"postal_code": "190873340",
"telephone_number": "610-772-1740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 STRAFFORD AVE STE 1",
"city": "WAYNE",
"state": "PA",
"postal_code": "190873340",
"telephone_number": "610-772-1740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKE",
"first_name": "ANDREA",
"credential": "DOM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NM",
"license": "958",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "OM000075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.