Provider Demographics
NPI:1285822056
Name:CIOTTI, ANDREW JAMES (NP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:JAMES
Last Name:CIOTTI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 BROADWAY
Mailing Address - Street 2:BLDG 5
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2711
Mailing Address - Country:US
Mailing Address - Phone:718-460-2046
Mailing Address - Fax:
Practice Address - Street 1:1167 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5417
Practice Address - Country:US
Practice Address - Phone:718-778-0198
Practice Address - Fax:718-221-8169
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401250363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NYW6L111Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331954Medicare Oscar/Certification