Provider Demographics
NPI:1790098838
Name:BUDAKOWSKI, ANDREW LEO (MSN CRNP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LEO
Last Name:BUDAKOWSKI
Suffix:
Gender:M
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ENFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2241
Mailing Address - Country:US
Mailing Address - Phone:609-835-1503
Mailing Address - Fax:609-835-1503
Practice Address - Street 1:650 EDISON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1237
Practice Address - Country:US
Practice Address - Phone:215-673-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008266363LA2200X
NJ26NJ00292200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health