Provider Demographics
NPI:1942216643
Name:MCANDREW, MARY GRACE (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:GRACE
Last Name:MCANDREW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:319 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3243
Mailing Address - Country:US
Mailing Address - Phone:908-537-4432
Mailing Address - Fax:908-604-5850
Practice Address - Street 1:151 KNOLLCROFT RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-604-5850
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07028800363LG0600X, 363LA2200X
NJ26NO07028800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered163W00000XNursing Service ProvidersRegistered Nurse