Provider Demographics
NPI:1629241278
Name:HUGO J. ANDREINI JR.,M.D.,INC.
Entity Type:Organization
Organization Name:HUGO J. ANDREINI JR.,M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDREINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-277-1766
Mailing Address - Street 1:40 MEDICAL PARK
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6392
Mailing Address - Country:US
Mailing Address - Phone:304-242-0779
Mailing Address - Fax:304-243-0653
Practice Address - Street 1:40 MEDICAL PARK
Practice Address - Street 2:SUITE 303
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6392
Practice Address - Country:US
Practice Address - Phone:304-242-0779
Practice Address - Fax:304-243-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14036174400000X
OH35057824174400000X
NJ25MAO4456100174400000X
PAMD034699E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0707060Medicaid
WV0130000000Medicaid
WV0130000000Medicaid
OH0707060Medicaid