Healthcare Provider Details

I. General information

NPI: 1790046365
Provider Name (Legal Business Name): GABRIELA ANDRADE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WASHINGTON AVE STE E1
HADDONFIELD NJ
08033-3341
US

IV. Provider business mailing address

30 WASHINGTON AVE STE E1
HADDONFIELD NJ
08033-3341
US

V. Phone/Fax

Practice location:
  • Phone: 856-300-2661
  • Fax: 844-927-4904
Mailing address:
  • Phone: 856-300-2661
  • Fax: 844-927-4904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD455961
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMT209459
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: