Provider Demographics
NPI:1740272582
Name:ANDROS-ANDRZEJEWSKA, PAULA M (OD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:M
Last Name:ANDROS-ANDRZEJEWSKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:18891 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6930
Mailing Address - Country:US
Mailing Address - Phone:440-268-0808
Mailing Address - Fax:440-268-0208
Practice Address - Street 1:18891 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6930
Practice Address - Country:US
Practice Address - Phone:440-268-0808
Practice Address - Fax:440-268-0208
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4819152W00000X, 152WP0200X, 152WS0006X, 152WV0400X
OHT1684152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU69121Medicare UPIN
OHANO838171Medicare ID - Type Unspecified