MEDICARE: DR. ANDREA JUE M.D.

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	207W00000X	Ophthalmology Physician	2608671	NY

General Provider Information

NPI Number	:	1699970129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA JUE M.D.

Provider Business Mailing Address
First Line	:	128 MOTT ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-5540
Country	:	US
Telephone Number	:	914-768-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 SULLIVAN AVENUE
Second Line	:	SUITE 540
City	:	DALY CITY
State	:	CA
Zip	:	94015-2215
Country	:	US
Telephone Number	:	650-755-6900
Fax Number	:	650-755-2107

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	12/26/2017

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