Provider Demographics
NPI:1154678811
Name:THET, ANDREA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:K
Last Name:THET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:THET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:230 HILTON AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-8116
Mailing Address - Country:US
Mailing Address - Phone:516-565-5200
Mailing Address - Fax:
Practice Address - Street 1:230 HILTON AVE STE 18
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8116
Practice Address - Country:US
Practice Address - Phone:516-565-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-12
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY285099207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist