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Individual

EDMUNDO B ANDRADA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
333 GRAND AVE, ENGLEWOOD, NJ 07631-4356
(201) 568-0900
Mailing address
317 REICHELT RD, APARTMENT D, NEW MILFORD, NJ 07646-6402
(201) 675-5217

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
40QA01237300
NJ

Other

Enumeration date
03/14/2007
Last updated
03/02/2008
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