Healthcare Provider Details

I. General information

NPI: 1518349356
Provider Name (Legal Business Name): ANDREA FERNANDA HERAS BARROS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2015
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 EAST 70TH STREET NEW YORK
NEW YORK NY
10021-1002
US

IV. Provider business mailing address

505 E 70TH ST FL 3
NEW YORK NY
10021-4872
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-3410
  • Fax:
Mailing address:
  • Phone: 646-962-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number285239
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number285239
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: