Healthcare Provider Details

I. General information

NPI: 1295771087
Provider Name (Legal Business Name): ANDREW J PORGES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 MARCUS AVE STE 306
NEW HYDE PARK NY
11042-1023
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 516-467-8600
  • Fax: 646-754-9821
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number171799
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: