Provider Demographics
NPI:1477674273
Name:JEFFRES, ANDREA LEE (ANNE JEFFRES)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LEE
Last Name:JEFFRES
Suffix:
Gender:F
Credentials:ANNE JEFFRES
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:JEFFRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANNE JEFFRES, DAOM
Mailing Address - Street 1:689 MYRTLE AVE APT 4H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3986
Mailing Address - Country:US
Mailing Address - Phone:425-451-7972
Mailing Address - Fax:
Practice Address - Street 1:689 MYRTLE AVE APT 4H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3986
Practice Address - Country:US
Practice Address - Phone:425-451-7972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000211171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist