Provider Demographics
NPI:1124011903
Name:KATZ, ANDREA G (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:G
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 STIRLING RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5751
Mailing Address - Country:US
Mailing Address - Phone:908-755-5437
Mailing Address - Fax:908-755-6905
Practice Address - Street 1:76 STIRLING RD
Practice Address - Street 2:STE 201
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5751
Practice Address - Country:US
Practice Address - Phone:908-755-5437
Practice Address - Fax:908-755-6905
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05609200208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ503382OtherAETNA HMO PIN
NJ47H052OtherEMPIRE HEALTH PLAN PIN
NJ0331009015OtherCIGNA PIN
NJ1034551OtherHORIZON NJ HEALTH, WARREN
NJ1082296OtherHORIZON NJ HEALTH, FANWOO
NJ12446OtherUNIVERSITY HEALTH PLAN
NJ1K3092OtherHEALTHNET ID NUMBER
NJ735547OtherAMERIHEALTH PPO PIN
NJ0639558000OtherAMERIHEALTH HMO PIN
NJ5149509Medicaid
NJTS106OtherOXFORD PIN