Provider Demographics
NPI:1255350583
Name:BLANK, ANDREW L (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:BLANK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:3526 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1954
Practice Address - Country:US
Practice Address - Phone:718-631-8899
Practice Address - Fax:718-631-4401
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-12-27
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Provider Licenses
StateLicense IDTaxonomies
NY169492207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE40710Medicare UPIN