Provider Demographics
NPI:1750486221
Name:ERIANNE, JOHN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:ERIANNE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:347 MOUNT PLEASANT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2744
Mailing Address - Country:US
Mailing Address - Phone:973-571-2121
Mailing Address - Fax:973-239-1591
Practice Address - Street 1:3285 JOHN F KENNEDY BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4228
Practice Address - Country:US
Practice Address - Phone:201-656-5263
Practice Address - Fax:201-656-3931
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2014-11-12
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02314200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2082306Medicaid
NJGU465924Medicare ID - Type Unspecified
NJ2082306Medicaid