Provider Demographics
NPI:1437163235
Name:ANDAZ, CHARUSHEELA (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:CHARUSHEELA
Middle Name:
Last Name:ANDAZ
Suffix:
Gender:F
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 8TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4718
Mailing Address - Country:US
Mailing Address - Phone:718-765-2550
Mailing Address - Fax:718-765-2569
Practice Address - Street 1:6300 8TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4718
Practice Address - Country:US
Practice Address - Phone:718-765-2550
Practice Address - Fax:718-765-2569
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214687208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG94914Medicare UPIN