Provider Demographics
NPI:1790872273
Name:KAPLAN, ANDREA B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:B
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:B
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:245 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2726
Mailing Address - Country:US
Mailing Address - Phone:631-465-6141
Mailing Address - Fax:631-465-1967
Practice Address - Street 1:2200 NORTHERN BLVD STE 116
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-609-0346
Practice Address - Fax:516-609-0353
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200525207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0627201Medicaid
NY646052Medicare ID - Type Unspecified
NY0627201Medicaid
NYG21613Medicare UPIN
NYA100000106Medicare PIN