| The Andante Center, Inc | |
|
6404 Roosevelt Blvd Suite 1d Philadelphia PA 19149-2943 | |
| (215) 744-5505 | |
| (215) 744-6374 |
| Full Name | The Andante Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6404 Roosevelt Blvd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Alexander Fine (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2157445505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Andante Center, Inc 6404 Roosevelt Blvd Suite 1d Philadelphia PA 19149-2943 Ph: (215) 744-5505 | The Andante Center, Inc 6404 Roosevelt Blvd Suite 1d Philadelphia PA 19149-2943 Ph: (215) 744-5505 |
| NPI Number | 1770806887 |
|---|---|
| Provider Enumeration Date | 03/03/2010 |
| Last Update Date | 03/03/2010 |
| Medicare PECOS PAC ID | 5799972303 |
|---|---|
| Medicare Enrollment ID | O20101208001120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770806887 | NPI | - | NPPES |
| 807411 | Other | PA | PA STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 807411 (Pennsylvania) | Primary |
| Provider Name | Jaspreet Singh Bains |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588003826 PECOS PAC ID: 8426284985 Enrollment ID: I20131112001041 |
| Provider Name | Alla Fine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497983563 PECOS PAC ID: 4789871252 Enrollment ID: I20140402001441 |
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