Provider Demographics
NPI:1760483960
Name:ANDELMAN, ROBERT JEROME (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEROME
Last Name:ANDELMAN
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 1:311 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1522
Mailing Address - Country:US
Mailing Address - Phone:603-749-2346
Mailing Address - Fax:603-953-0066
Practice Address - Street 1:8 GREENLEAF WOODS DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5436
Practice Address - Country:US
Practice Address - Phone:603-422-8208
Practice Address - Fax:603-422-8218
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH4995207L00000X
NH4995207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80000187Medicaid
NHB85946Medicare UPIN
NHRE0187Medicare PIN