MEDICARE: DR. ALAN DOUGLAS ANDREWS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	25MA04601400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104990035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN DOUGLAS ANDREWS M.D.

Provider Business Mailing Address
First Line	:	500 PIERMONT RD STE 101
Second Line	:
City	:	CLOSTER
State	:	NJ
Zip	:	07624-2846
Country	:	US
Telephone Number	:	201-767-0501
Fax Number	:	201-767-7904

Provider Business Practice Location Address
First Line	:	500 PIERMONT RD
Second Line	:
City	:	CLOSTER
State	:	NJ
Zip	:	07624-2845
Country	:	US
Telephone Number	:	201-767-0501
Fax Number	:	201-767-7904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	10/30/2025

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