Provider Demographics
NPI:1033131099
Name:ULICHNEY, ANDREW BERNARD II (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BERNARD
Last Name:ULICHNEY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 E PENNSYLVANIA AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2602
Mailing Address - Country:US
Mailing Address - Phone:610-280-7960
Mailing Address - Fax:610-280-7962
Practice Address - Street 1:150 E PENNSYLVANIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2602
Practice Address - Country:US
Practice Address - Phone:610-280-7960
Practice Address - Fax:610-280-7962
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062918L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G68304Medicare UPIN
008054QZQMedicare ID - Type UnspecifiedINDIVIDUAL
62800Medicare ID - Type UnspecifiedGROUP
460496115OtherFIRST HEALTH GROUP
0200775004OtherCIGNA INDIVIDUAL
G68304Medicare UPIN
008054QZQMedicare ID - Type UnspecifiedINDIVIDUAL
0642539000OtherKEYSTONE E AMERI HLT IND
110241512OtherRR MEDICARE GROUP
62800Medicare ID - Type UnspecifiedGROUP
1413420OtherPA BLUE SHIELD GROUP
460496115OtherMAMSI GROUP
138111OtherAETNA HMO GROUP
460496115OtherDEVON HEALTH GROUP
1413420OtherINDEPENDENCE BC GROUP
278657OtherINDEPENDENCE BC INDIVIDUA
460496115OtherINTERGROUP GROUP
5089653OtherAETNA PPO INDIVIDUAL
278657OtherPA BLUE SHIELD INDIVIDUAL
460496115OtherPHCS GROUP