Provider Demographics
NPI:1669448890
Name:MORING, ANDREW F (PA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:F
Last Name:MORING
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 HAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2584
Mailing Address - Country:US
Mailing Address - Phone:508-753-2060
Mailing Address - Fax:508-752-4244
Practice Address - Street 1:250 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2584
Practice Address - Country:US
Practice Address - Phone:508-753-2060
Practice Address - Fax:508-752-4244
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA320363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP0903Medicare PIN
MAS63942Medicare UPIN
MAQX0846Medicare PIN