Provider Demographics
NPI:1295771087
Name:PORGES, ANDREW J (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:PORGES
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 1:1999 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1033
Practice Address - Country:US
Practice Address - Phone:516-467-8600
Practice Address - Fax:646-754-9821
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171799174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3031654OtherAETNA
NYP2828820OtherOXFORD
NY34458OtherVYTRA
NY01193755Medicaid
NY4C5382OtherHEALTHNET
NY113662047OtherEMPIRE PLAN
NYP00071789OtherRAILROAD MEDICARE
NY113662047OtherUNITED HEALTHCARE
NY1799901OtherGHI
NY113662047OtherCIGNA
NY115647POtherHIP
NYP00071789OtherRAILROAD MEDICARE
NY1799901OtherGHI