Provider Demographics
NPI:1609034875
Name:ANDOLINO, TECILE TRAKESHIA PRINCE (MD)
Entity type:Individual
Prefix:DR
First Name:TECILE
Middle Name:TRAKESHIA PRINCE
Last Name:ANDOLINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TECILE
Other - Middle Name:TRAKESHIA
Other - Last Name:PRINCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5425 LANARK RD
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8697
Mailing Address - Country:US
Mailing Address - Phone:484-658-5437
Mailing Address - Fax:
Practice Address - Street 1:5425 LANARK RD
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8697
Practice Address - Country:US
Practice Address - Phone:484-658-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01068479208000000X
PAMD4526042080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics