MEDICARE: MARIA RITA P. ANDAYA 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	207R00000X	Internal Medicine Physician	207380-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00081666	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00020009402	OTHER	NY	UNIVERA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000524448002	OTHER	NY	BLUE CROSS BLUE SHIELD
5	0408441	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1639102874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA RITA P. ANDAYA M.D.

Provider Business Mailing Address
First Line	:	1344 MCKINLEY PKWY
Second Line	:
City	:	LACKAWANNA
State	:	NY
Zip	:	14218-1643
Country	:	US
Telephone Number	:	716-549-4724
Fax Number	:

Provider Business Practice Location Address
First Line	:	286 N MAIN ST
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-1032
Country	:	US
Telephone Number	:	716-549-4724
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	02/27/2008

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