Provider Demographics
NPI:1144754086
Name:ORENBERG, ANDREW
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:ORENBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WIDGER RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-2100
Mailing Address - Country:US
Mailing Address - Phone:781-696-8490
Mailing Address - Fax:
Practice Address - Street 1:1 WIDGER RD STE 108
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2100
Practice Address - Country:US
Practice Address - Phone:781-631-8300
Practice Address - Fax:781-639-9017
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA287387207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology