Provider Demographics
NPI:1821750688
Name:DEONARINE, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:DEONARINE
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 1:146 ARNOLD CRESCENT
Mailing Address - Street 2:
Mailing Address - City:ANGUS
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L0M1B6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 ARNOLD CRESCENT
Practice Address - Street 2:
Practice Address - City:ANGUS
Practice Address - State:ONTARIO
Practice Address - Zip Code:L0M1B6
Practice Address - Country:CA
Practice Address - Phone:617-401-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT571252083C0008X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics