Healthcare Provider Details

I. General information

NPI: 1447169156
Provider Name (Legal Business Name): ANDREWS LARTEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5589
US

IV. Provider business mailing address

10994 202ND ST
JAMAICA NY
11412-1333
US

V. Phone/Fax

Practice location:
  • Phone: 844-692-4692
  • Fax:
Mailing address:
  • Phone: 929-499-8423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130559
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: