Healthcare Provider Details

I. General information

NPI: 1841575552
Provider Name (Legal Business Name): ANDREW FRUHSCHIEN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FRANKLIN TPKE
MAHWAH NJ
07430-1304
US

IV. Provider business mailing address

20 GRAND ST FL 3
WARWICK NY
10990-1035
US

V. Phone/Fax

Practice location:
  • Phone: 201-529-0033
  • Fax: 201-529-5913
Mailing address:
  • Phone: 845-987-3906
  • Fax: 845-987-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NR13696200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00339200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00339200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: