Provider Demographics
NPI:1548598758
Name:ZUCKERMAN, A NDREA (MD)
Entity Type:Individual
Prefix:
First Name:A NDREA
Middle Name:
Last Name:ZUCKERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1930
Mailing Address - Country:US
Mailing Address - Phone:914-219-1145
Mailing Address - Fax:
Practice Address - Street 1:90 W SHORE DR
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-1930
Practice Address - Country:US
Practice Address - Phone:914-672-2806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-28
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1658632080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology