Provider Demographics
NPI:1659661643
Name:KASOWITZ, ANDREA RUTH (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:RUTH
Last Name:KASOWITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 BLOOMFIELD AVE
Mailing Address - Street 2:#201
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:799 BLOOMFIELD AVE
Practice Address - Street 2:#201
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1374
Practice Address - Country:US
Practice Address - Phone:973-746-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program