Provider Demographics
NPI:1073845368
Name:KNYBEL, ANDREA C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:C
Last Name:KNYBEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 94TH ST APT 218
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3904
Mailing Address - Country:US
Mailing Address - Phone:404-310-4958
Mailing Address - Fax:
Practice Address - Street 1:1324 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5408
Practice Address - Country:US
Practice Address - Phone:212-752-7703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052108-1183500000X
GARPH021710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist