Provider Demographics
NPI:1881635084
Name:SHANAHAN, ANDREW J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:SHANAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:731 ALEXANDER ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-921-7456
Mailing Address - Fax:609-921-2972
Practice Address - Street 1:731 ALEXANDER ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-921-7456
Practice Address - Fax:609-921-2972
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06373200207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2905975012OtherCIGNA
NJ874621OtherAMERIHEALTH PPO
0989950000OtherAMERIHEALTH
NJ1481871OtherUNITED HEALTHCARE
NJ60058075OtherMEDICARE RAILROAD
NJ6956106Medicaid
NJF10830OtherHEALTHNET
P711524OtherOXFORD
141188OtherGHI
NJ940913OtherAETNA
P711524OtherOXFORD
NJG28645Medicare UPIN
NJ6956106Medicaid