MEDICARE: ANDREA MARIE WARD DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N004627	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	172633	OTHER	NY	ELDER PLAN
3	N004627B58	OTHER	NY	HEALTH FIRST

General Provider Information

NPI Number	:	1316937493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE WARD DPM

Provider Business Mailing Address
First Line	:	1374 MAIN ST
Second Line	:
City	:	STRATFORD
State	:	CT
Zip	:	06615-7021
Country	:	US
Telephone Number	:	203-385-8595
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 W 116TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-2416
Country	:	US
Telephone Number	:	212-222-7800
Fax Number	:	212-222-7955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	12/19/2007

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