Provider Demographics
NPI:1033251632
Name:STRAUSS, ANDREA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LEE
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3109
Mailing Address - Country:US
Mailing Address - Phone:908-725-4600
Mailing Address - Fax:908-725-4603
Practice Address - Street 1:331 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3109
Practice Address - Country:US
Practice Address - Phone:908-725-4600
Practice Address - Fax:908-725-4603
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05480600208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F05165Medicare UPIN
689980BKAMedicare PIN