MEDICARE: ANDREA WARD DPM PC

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

General Provider Information

NPI Number	:	1649454869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREA WARD DPM PC

Provider Business Mailing Address
First Line	:	1374 MAIN ST
Second Line	:
City	:	STRATFORD
State	:	CT
Zip	:	06615-7021
Country	:	US
Telephone Number	:
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	:	SOLE PROPRIETOR
Name	:	ANDREA WARD
Credential	:	D.P.M.
Telephone Number	:	212-222-7800

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	12/03/2010

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