Provider Demographics
NPI:1811877020
Name:ANDRETTA, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ANDRETTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 FIR AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-9090
Mailing Address - Country:US
Mailing Address - Phone:570-765-9279
Mailing Address - Fax:
Practice Address - Street 1:719 ROUTE 522
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-1211
Practice Address - Country:US
Practice Address - Phone:570-374-1210
Practice Address - Fax:570-374-5748
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X
PAPI27098390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No183700000XPharmacy Service ProvidersPharmacy Technician