Healthcare Provider Details

I. General information

NPI: 1841821345
Provider Name (Legal Business Name): ANDREW METH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HOPE AVE # 312
WALTHAM MA
02453-2721
US

IV. Provider business mailing address

10327 ILONA AVE
LOS ANGELES CA
90064-2503
US

V. Phone/Fax

Practice location:
  • Phone: 617-286-2660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: