Provider Demographics
NPI:1033251442
Name:DRAKE, ANDREW F (DO,)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:F
Last Name:DRAKE
Suffix:
Gender:M
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-463-2755
Mailing Address - Fax:609-463-2757
Practice Address - Street 1:3806 BAYSHORE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-3208
Practice Address - Country:US
Practice Address - Phone:609-898-7447
Practice Address - Fax:609-898-1912
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB33701207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2248701Medicaid
NJ2248701Medicaid
NJD18635Medicare UPIN