Provider Demographics
NPI:1720378185
Name:AHWENG, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:AHWENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WILLOUGHBY ST
Mailing Address - Street 2:APARTMENT 14 H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5465
Mailing Address - Country:US
Mailing Address - Phone:718-887-4912
Mailing Address - Fax:
Practice Address - Street 1:240 WILLOUGHBY ST
Practice Address - Street 2:APARTMENT 14H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5465
Practice Address - Country:US
Practice Address - Phone:718-887-4912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC158732208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery