Basic Information
| Provider Information | |||||||||
| NPI: | 1386038792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | DEIRDRE | ||||||||
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| Credential: | M..D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 SPRING BROOK DR | ||||||||
| Address2: | |||||||||
| City: | ANNANDALE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088011642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082163772 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1738 ROUTE 31 NORTH | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | CLINTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087354645 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2015 | ||||||||
| LastUpdateDate: | 10/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA09793700 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.