Provider Demographics
NPI:1023151610
Name:WAS, ANDREW RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RICHARD
Last Name:WAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WEST END AVENUE
Mailing Address - Street 2:DOCTORS' OFFICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-874-1116
Mailing Address - Fax:212-496-0206
Practice Address - Street 1:495 WEST END AVENUE
Practice Address - Street 2:DOCTORS' OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-874-1116
Practice Address - Fax:212-496-0206
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY199520OtherHORIZON
NY199520OtherAFTRA
NYP1090038OtherOXFORD
NYX19952OtherPOM
NY4127847OtherMVP
NY4410785OtherAETNA
NY000649978004OtherUNITED HEALTHCARE
NY199520OtherCA803
NY199520OtherWBCAFE
NY0345BOtherLANDMARK
NYX19952OtherHEALTHNET
NYX19952OtherGHI
NYX19952OtherHEALTHNET