Provider Demographics
NPI:1306183058
Name:KRISPINSKY, ANDREW JOHN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:KRISPINSKY
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 1:218 SIR OLIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4443
Mailing Address - Country:US
Mailing Address - Phone:757-675-7970
Mailing Address - Fax:
Practice Address - Street 1:USS GUNSTON HALL
Practice Address - Street 2:UNIT 100259 BOX 100
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09573-1732
Practice Address - Country:US
Practice Address - Phone:757-675-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256702208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice