Provider Demographics
NPI:1033741327
Name:BAEZ RIVERA, ANDREW STEVEN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEVEN
Last Name:BAEZ RIVERA
Suffix:
Gender:M
Credentials:
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 366928
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6928
Mailing Address - Country:US
Mailing Address - Phone:787-688-7326
Mailing Address - Fax:
Practice Address - Street 1:THE GW MEDICAL FACULTY ASSOCIATES
Practice Address - Street 2:2150 PENNSYLVANIA AVE, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program