Provider Demographics
NPI:1881831220
Name:PERRINE, A'NDREA GABRIELLE
Entity Type:Individual
Prefix:MRS
First Name:A'NDREA
Middle Name:GABRIELLE
Last Name:PERRINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 BEST RD
Mailing Address - Street 2:
Mailing Address - City:WEST SAND LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12196-2806
Mailing Address - Country:US
Mailing Address - Phone:518-283-0506
Mailing Address - Fax:
Practice Address - Street 1:108 EDUCATION DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1238
Practice Address - Country:US
Practice Address - Phone:518-370-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008955-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist