Basic Information
| Provider Information | |||||||||
| NPI: | 1649513813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MILES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10850 71ST AVE APT 3G | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113754524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162636928 | ||||||||
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| Practice Location | |||||||||
| Address1: | 103 RIVER RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | EDGEWATER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070201016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016546397 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2013 | ||||||||
| LastUpdateDate: | 11/06/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 25MB10182700 | NJ | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 295281 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.