Provider Demographics
NPI:1477759801
Name:COMBS, ANDREW J (PA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:COMBS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:BOX 94
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-5361
Mailing Address - Fax:212-746-8065
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX 94
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-5361
Practice Address - Fax:212-746-8065
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY001149363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant