Provider Demographics
NPI:1053480350
Name:ORPHANIDES, ANDREA L (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:L
Last Name:ORPHANIDES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 OMNI DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4527
Mailing Address - Country:US
Mailing Address - Phone:908-874-8600
Mailing Address - Fax:
Practice Address - Street 1:405 OMNI DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4527
Practice Address - Country:US
Practice Address - Phone:908-874-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered