Provider Demographics
NPI:1114199064
Name:ANDRIESCU, YELENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:ANDRIESCU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 EDGEWATER TOWNE CTR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1246
Mailing Address - Country:US
Mailing Address - Phone:201-945-1600
Mailing Address - Fax:201-945-1615
Practice Address - Street 1:23 EDGEWATER TOWNE CTR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1246
Practice Address - Country:US
Practice Address - Phone:201-945-1600
Practice Address - Fax:201-945-1615
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02248200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist