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Individual

ANDREA ENDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6987
Mailing address
8710 51ST AVE APT 5G, ELMHURST, NY 11373-3916

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308218
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
308218
NY
Enumeration date
07/06/2017
Last updated
07/06/2017
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