Provider Demographics
NPI:1144453879
Name:STONE, ANDREA N (PT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:N
Last Name:STONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WESTERN MARYLAND PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5471
Mailing Address - Country:US
Mailing Address - Phone:301-797-6389
Mailing Address - Fax:301-797-4119
Practice Address - Street 1:17 WESTERN MARYLAND PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5471
Practice Address - Country:US
Practice Address - Phone:301-797-6389
Practice Address - Fax:301-797-4119
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00854250OtherRR MEDICARE MD
MD95627601OtherBCBS LOCAL CAREFIRST KG85
MD418531500Medicaid
MDW2660023OtherBCBS REGIONAL CAREFIRST W266
MD167963YQUMedicare PIN