Healthcare Provider Details

I. General information

NPI: 1962968313
Provider Name (Legal Business Name): C. DANDREA MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 FAIRFIELD RD
FAIRFIELD NJ
07004-2407
US

IV. Provider business mailing address

150 FAIRFIELD RD
FAIRFIELD NJ
07004-2407
US

V. Phone/Fax

Practice location:
  • Phone: 201-317-4590
  • Fax:
Mailing address:
  • Phone: 201-317-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER R DANDREA
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: MD
Phone: 201-317-4590