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Individual

DR. JAVIER ENRIQUE ANDRADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7000
Mailing address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP1-0027563
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4623933177
MYUTMB 4623933177-COMMERCIAL NUMBER
Enumeration date
06/14/2007
Last updated
09/18/2014
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