Provider Demographics
NPI:1477590685
Name:PRICE, ANDREA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:N
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:N
Other - Last Name:PRICE-RUTTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:354 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2329
Mailing Address - Country:US
Mailing Address - Phone:732-542-3800
Mailing Address - Fax:848-456-4476
Practice Address - Street 1:354 BROAD ST
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2329
Practice Address - Country:US
Practice Address - Phone:732-542-3800
Practice Address - Fax:848-456-4476
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72626207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0004197Medicaid
NJ071479Medicare ID - Type Unspecified
NJ0004197Medicaid