Provider Demographics
NPI:1447323241
Name:TARSICI, ANDREI LIVIU (ATC)
Entity type:Individual
Prefix:
First Name:ANDREI
Middle Name:LIVIU
Last Name:TARSICI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 S 4TH ST
Mailing Address - Street 2:APT. 7
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1866
Mailing Address - Country:US
Mailing Address - Phone:570-713-9578
Mailing Address - Fax:
Practice Address - Street 1:MOORE AVENUE
Practice Address - Street 2:KLARC
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-577-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0036202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer