Healthcare Provider Details

I. General information

NPI: 1033251442
Provider Name (Legal Business Name): ANDREW F DRAKE D.O,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3806 BAYSHORE RD SUITE 101
NORTH CAPE MAY NJ
08204-3208
US

IV. Provider business mailing address

PO BOX 593
CAPE MAY COURT HOUSE NJ
08210-0593
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-7447
  • Fax: 609-898-1912
Mailing address:
  • Phone: 609-463-2755
  • Fax: 609-463-2757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB33701
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: