Provider Demographics
NPI:1710938667
Name:BEAR, ANDREW SCOTT (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:BEAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TOWNE CTR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1345
Mailing Address - Country:US
Mailing Address - Phone:973-584-4600
Mailing Address - Fax:973-584-9359
Practice Address - Street 1:66 TOWNE CTR
Practice Address - Street 2:SUITE 306
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1345
Practice Address - Country:US
Practice Address - Phone:973-584-4600
Practice Address - Fax:973-584-9359
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00237000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7324502Medicaid
NJ7324502Medicaid
NJ908217C7GMedicare ID - Type Unspecified