Provider Demographics
NPI:1750327623
Name:DEOLIVEIRA, ANDREW XAVIER (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:XAVIER
Last Name:DEOLIVEIRA
Suffix:
Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:257 ROSELLE ST
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2125
Mailing Address - Country:US
Mailing Address - Phone:516-746-7960
Mailing Address - Fax:
Practice Address - Street 1:1300 UNION TPKE
Practice Address - Street 2:SUITE 108
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-488-2743
Practice Address - Fax:516-488-6249
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-21
Last Update Date:2023-09-07
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Provider Licenses
StateLicense IDTaxonomies
NY010737363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical