Provider Demographics
NPI:1265401889
Name:CORWIN, ANDREW D (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:CORWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E 149TH ST # 5-18
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5504
Mailing Address - Country:US
Mailing Address - Phone:718-579-5830
Mailing Address - Fax:718-579-4699
Practice Address - Street 1:234 E 149TH ST # 5-18
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5830
Practice Address - Fax:718-579-4699
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ53657207V00000X
NY179339207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01648920Medicaid
NYE86593Medicare UPIN
NY01648920Medicaid
NJE86593Medicare UPIN