Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD01305E | PA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD01305E | PA |
NPI | 1104855394 |
---|---|
Provider Name | Dr. Andrew Edward Hickey |
First Address | Dallastown, PA 17313-2111 |
Second Address | Dallastown, PA 17313-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 20/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000641857 | (05) | PA |
12739 | JOHNS HOPKINS (01) | PA |
191576 | HIGHMARK BLUE SHIELD (01) | PA |
20005817 | AMERIHEALTH MERCY-WMG (01) | PA |
5336310 | AETNA (01) | PA |
76586 | GEISINGER (01) | PA |
998048 | UPMC (01) | PA |
C27902 | (02) | PA |
P004692 | GATEWAY-WMG (01) | PA |