Individual
DR. PETER ANDRADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
293510
NY
208600000X
Surgery Physician
25MB10124900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12785099
CAQH
—
01
—
1417287707
NPI
—
01
—
1588246433
NPI
—
01
—
1780276816
NPI
—
01
—
25MB10124900
NJ MEDICAL LICENSE
NJ
01
—
293510
NY MED LICENSE
NY
01
—
7430432372
NRCME
—
Enumeration date
01/08/2010
Last updated
01/03/2023
Update your record
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