Provider Demographics
NPI:1679517361
Name:LAWS, ANDREW G (OT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:G
Last Name:LAWS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 LIMESTONE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5413
Mailing Address - Country:US
Mailing Address - Phone:302-655-9494
Mailing Address - Fax:302-691-1478
Practice Address - Street 1:1941 LIMESTONE RD STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5413
Practice Address - Country:US
Practice Address - Phone:302-655-9494
Practice Address - Fax:302-691-1478
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000828225X00000X, 224Z00000X
PAOC004744L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2123122OtherPA BLUE SHIELD
000050230OtherDPCI
DE3765963000OtherAMERIHEALTH
PA102306334Medicaid
PA129322VLZOtherMEDICARE
DE1679517361Medicaid
P00692868OtherRAILROAD MEDICARE
DE012618D81Medicare ID - Type Unspecified
DE012617D80Medicare ID - Type Unspecified
DE1679517361Medicaid
P99478Medicare UPIN
PA102306334Medicaid