Andrea Lilly Dievendorf, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X0108561 Issued in NY

Practice address

2 Chelsea PL
Clifton Park, NY 12065-3227

Phone

(518) 373-6545

NPI assigned

Dec 6, 2005

Last updated

Aug 25, 2016By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1225012800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHELSEA PL",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653227",
            "telephone_number": "518-373-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHELSEA PL",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653227",
            "telephone_number": "518-373-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEVENDORF",
        "first_name": "ANDREA",
        "middle_name": "LILLY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0108561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "2601222001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7016671",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "NY23902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Roeske Di Palma, RN
• Dialysis Clinic Inc (DCI-Rubin Dialysis Centers)
• Miguel Elias Diaz-Wege, LMHC
• Brenda Dickenson, LMT
• Kimberly Dickson, RPH
• Michael Joseph Dillon, M.S., R.PH.
• Dinapoli & Dinapoli, Inc.
• Katina Dinehart
• Jlea Dinon, RN
• Distance Therapies Occupational Therapy, PLLC (Saratoga Sensory)

• Chiropractor in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.