Healthcare Provider Details

I. General information

NPI: 1922764133
Provider Name (Legal Business Name): ANDREA HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9116 101ST AVE
OZONE PARK NY
11416-2219
US

IV. Provider business mailing address

9116 101ST AVE
OZONE PARK NY
11416-2219
US

V. Phone/Fax

Practice location:
  • Phone: 845-893-4169
  • Fax:
Mailing address:
  • Phone: 845-893-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY ANDREA
Title or Position: OWNER
Credential: DPM
Phone: 718-482-0010