Provider Demographics
NPI:1790063121
Name:NIGHTINGALE, ANDREW BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BRADLEY
Last Name:NIGHTINGALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:211 CENTRAL PARK W # 1E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6020
Mailing Address - Country:US
Mailing Address - Phone:212-877-7188
Mailing Address - Fax:212-877-3912
Practice Address - Street 1:211 CENTRAL PARK W # 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6020
Practice Address - Country:US
Practice Address - Phone:212-877-7188
Practice Address - Fax:212-877-3912
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY265586207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology