Provider Demographics
NPI:1205033990
Name:GREENFELD, ANDREA H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:H
Last Name:GREENFELD
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 1:25 LEAVEY DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4437
Mailing Address - Country:US
Mailing Address - Phone:603-314-6500
Mailing Address - Fax:603-314-6509
Practice Address - Street 1:25 LEAVEY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-314-6500
Practice Address - Fax:603-314-6509
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6210207R00000X, 208000000X
NH18796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD9865Medicaid
AKMD9865Medicaid