Provider Demographics
NPI:1568127553
Name:METTIAS, ANDREW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:METTIAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BERKSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5286
Mailing Address - Country:US
Mailing Address - Phone:732-742-0510
Mailing Address - Fax:
Practice Address - Street 1:3 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5037
Practice Address - Country:US
Practice Address - Phone:732-432-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04216600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist