Provider Demographics
NPI:1760650931
Name:ROBERT ANDRIA M.D.,P.C.
Entity Type:Organization
Organization Name:ROBERT ANDRIA M.D.,P.C.
Other - Org Name:ROBERT ANDRIA M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-332-8181
Mailing Address - Street 1:158 BRIGHTON 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5327
Mailing Address - Country:US
Mailing Address - Phone:718-332-8181
Mailing Address - Fax:718-332-7898
Practice Address - Street 1:158 BRIGHTON 11TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5325
Practice Address - Country:US
Practice Address - Phone:718-332-8181
Practice Address - Fax:718-332-7898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT ANDRIA M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-11
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY45A471Medicare PIN