Individual
ANDY NAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9425 60TH AVE, ELMHURST, NY 11373-5069
(718) 760-0797
Mailing address
209 EVERGREEN AVE, BETHPAGE, NY 11714-1221
(347) 384-0521
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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