Provider Demographics
NPI:1023013059
Name:ANDIN, PERLA JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:PERLA
Middle Name:JOYCE
Last Name:ANDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PERLA
Other - Middle Name:JOYCE
Other - Last Name:ANDIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2 COATES DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6758
Mailing Address - Country:US
Mailing Address - Phone:845-651-1400
Mailing Address - Fax:845-651-1512
Practice Address - Street 1:905 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5522
Practice Address - Country:US
Practice Address - Phone:845-564-7066
Practice Address - Fax:845-549-1044
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400046509OtherMEDICARE
NY01988861Medicaid
A400046509OtherMEDICARE
NY01988861Medicaid