Provider Demographics
NPI:1598452260
Name:ANDREWS, MIRIAM (APN)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:MALDONADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:484 S FIR AVE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4418
Mailing Address - Country:US
Mailing Address - Phone:609-432-1655
Mailing Address - Fax:
Practice Address - Street 1:7 S OHIO AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6711
Practice Address - Country:US
Practice Address - Phone:609-572-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14933600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine