=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790221125
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW PFLEGER PA-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2017
-----------------------------------------------------
Last Update Date | 12/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 160 E HANOVER AVE STE 201
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960-3150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-538-0900
-----------------------------------------------------
Fax | 973-538-0909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 107 FOREST LAKE DR N
-----------------------------------------------------
City | BYRAM TOWNSHIP
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07821-4017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-399-5240
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number | 25MP00420400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 25MP00420400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------