Provider Demographics
NPI:1669737565
Name:FEBLES, ANDREA DEE (S E TEACHER)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DEE
Last Name:FEBLES
Suffix:
Gender:F
Credentials:S E TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1318
Mailing Address - Country:US
Mailing Address - Phone:631-375-4228
Mailing Address - Fax:
Practice Address - Street 1:126 MONTROSE DR
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1318
Practice Address - Country:US
Practice Address - Phone:631-375-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2012-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist