Provider Demographics
NPI:1356348437
Name:ANDRICH, ALEXANDAR (OD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDAR
Middle Name:
Last Name:ANDRICH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10139 ROYALTON RD
Mailing Address - Street 2:STE D
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-4473
Mailing Address - Country:US
Mailing Address - Phone:330-915-3007
Mailing Address - Fax:330-319-6390
Practice Address - Street 1:10139 ROYALTON RD
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-4472
Practice Address - Country:US
Practice Address - Phone:440-230-0923
Practice Address - Fax:440-786-5086
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4693/T1471152WP0200X, 152WS0006X, 152WV0400X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0240939Medicaid
OHU64857Medicare UPIN
OH0240939Medicaid