Provider Demographics
NPI:1467602201
Name:THE, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:THE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ORIENT WAY STE BB
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2145
Mailing Address - Country:US
Mailing Address - Phone:201-438-6916
Mailing Address - Fax:201-438-4227
Practice Address - Street 1:130 ORIENT WAY STE BB
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2145
Practice Address - Country:US
Practice Address - Phone:201-438-6916
Practice Address - Fax:201-438-4227
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434324207R00000X
NJ25MA08785100207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine