Mark Kenneth Andrew, MSPT
Individual provider Active NPI Physical Therapist · Providence, RI
NPI 1336212232 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336212232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1922 (RI)
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 444-5418
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1922 | RI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1922 | RI | Yes |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
7 Cecile St
Lincoln, RI 02865-3209
Phone (401) 864-5723
Other providers in Providence, RI
- Susan Andre
- Gage Andreoli-Holmquist
- Emmanuel Andreoulakis
- Michaela Andreozzi
- Lisha Andrew
- Heidi Andrews-Leahy
- Ellen Louise Andrews-Manocchia
- Nicholas Anthony Andrews
- Robert Joseph Andrews
- Kristen Andriole
All providers in Providence, RI · Physical Therapist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.