Provider Demographics
NPI:1548011026
Name:CHADWICK ANDRUSISIN, KAITLYN MARIEL (DO)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:MARIEL
Last Name:CHADWICK ANDRUSISIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:MARIEL
Other - Last Name:CHADWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3600 FORBES AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BRADY MEDICAL ARTS BUILDING 205 S FRONT STREET
Practice Address - Street 2:9TH FLOOR, SUITE 908
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104
Practice Address - Country:US
Practice Address - Phone:717-231-8494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program