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Contact Information

ANDREW G PRENDERGAST
601 CLEVELAND AVE NW
CANTON, OH44702-1836
 Phone: 330-455-0374
 Fax: 330-453-6716
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prevention Professional

405300000X
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for ANDREW G PRENDERGAST · (Male)

NPI # 1104309335
Status Active
Credentials
Entity Individual
Enumeration date 09/13/2018
Last updated 10/25/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OH License # OCPSA.161356
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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