Provider Demographics
NPI:1972660496
Name:SAVOPOULOS, ANDREAS ALEXANDROS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:ALEXANDROS
Last Name:SAVOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:973-669-5931
Mailing Address - Fax:973-669-7342
Practice Address - Street 1:401 PLEASANT VALLEY WAY
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-669-5931
Practice Address - Fax:973-669-7342
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ34400207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ158100701Medicaid
NJ452763Medicare ID - Type Unspecified
C55372Medicare UPIN