Provider Demographics
NPI:1114102498
Name:JOB, ANDREA L (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:L
Last Name:JOB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 6TH ST
Mailing Address - Street 2:NEW YORK METHODIST HOSPITAL, DIVISION OF CARDIOLOGY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:718-780-3626
Mailing Address - Fax:718-780-7717
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:NEW YORK METHODIST HOSPITAL, DIVISION OF CARDIOLOGY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3626
Practice Address - Fax:718-780-7717
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009233363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant