Provider Demographics
NPI:1669656815
Name:REIN, ANDREA JILL (APN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JILL
Last Name:REIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JILL
Other - Last Name:STORPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:407 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-1201
Mailing Address - Country:US
Mailing Address - Phone:201-567-3045
Mailing Address - Fax:
Practice Address - Street 1:223 N VAN DIEN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2726
Practice Address - Country:US
Practice Address - Phone:201-447-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08459100363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care