Person

Andrew Medvedovsky

Debarred entity

United States. Named in 3 sanctions listings.

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Summary

License number: 101248161

Sanctions and listings3

  • Effective
    4 Aug 2020

    Official designation

    Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded

    pa.gov

  • Effective
    4 Aug 2020

    Official designation

    New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States

    DISQUALIFICATION

    nj.gov

  • Effective
    4 Aug 2020

    Official designation

    Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States

    Terminate Provider Agreement-Terminated- Reporting Only Managed Care

    medicaid.dhss.delaware.gov

Identifiers2

IdentifierNumber
ID numberMD468530
NPI number1649431594

Other names1

Also known as1

MEDVEDOVSKY, ANDREW

Addresses3

  • 11 AUTUMN DRIVE, MOORESTOWN, NJ 08057

  • (NJ), (NJ)

  • NJ, NJ

    United States

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