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General NPI Number Information
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NPI Number | 1801123617
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Entity Type | Organization
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Legal Business Name | ANDRADE MEDICAL PLLC
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 1163 MANOR AVE FRNT 2
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City | BRONX
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State | NY
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Zip | 10472-3972
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Country | US
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Telephone | 718-589-3501
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Fax | 718-589-1012
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Provider Business Mailing Address
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Address Line | 1163 MANOR AVE FRNT 2
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City | BRONX
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State | NY
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Zip | 10472-3972
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Country | US
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Telephone | 718-589-3501
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Fax | 718-589-1012
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Authorized Official
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Title or Position | CRED MANAGER
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Name | MR. DAVID JACOB
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Credential |
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Telephone | 347-650-2775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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