Provider Demographics
NPI:1609118298
Name:D'ANDREA, CHRISTOPHER RALPH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RALPH
Last Name:D'ANDREA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LB#7550
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:
Practice Address - Street 1:3175 STATE ROUTE 10 BUILDING C, SUITE 500
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:201-317-4590
Practice Address - Fax:973-343-2134
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09769900207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine