Provider Demographics
NPI:1851480800
Name:JOSEPH, D'ANDREA K (MD)
Entity Type:Individual
Prefix:
First Name:D'ANDREA
Middle Name:K
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SEYMOUR STREET
Mailing Address - Street 2:HARTFORD HOSPITAL SURGERY DEPT
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-5037
Mailing Address - Country:US
Mailing Address - Phone:860-972-2840
Mailing Address - Fax:
Practice Address - Street 1:700 STEWART AVE STE 200
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4726
Practice Address - Country:US
Practice Address - Phone:516-663-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA077355002086S0102X
NY261213208600000X
CT0499982086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0036889Medicaid
NJ3560222OtherAETNA
NJ1653267OtherAMERIHEALTH PPO/PA BS
NJP3344898OtherOXFORD
NJ3560217OtherAETAN
NJ3K6048OtherHEALTHNET
NJ60008155OtherHORIZON NJ HEALTH
NJ2521591OtherUNITED HEALTHCARE
NJ2329854000OtherAMERIHEALTH/KEYSTONE/IBC
NJ010006147OtherAMERICHOICE
NJ42320OtherUNIVERSITY HEALTH PLAN
NJ0036889Medicaid
NJ083767 SH7Medicare PIN
NJ083767AN0Medicare PIN