Provider Demographics
NPI:1801150867
Name:ANDREWS ADADE MD, PC
Entity type:Organization
Organization Name:ANDREWS ADADE MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREWS
Authorized Official - Middle Name:ADU
Authorized Official - Last Name:ADADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-327-9333
Mailing Address - Street 1:18 HILLANDALE AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2808
Mailing Address - Country:US
Mailing Address - Phone:203-327-9333
Mailing Address - Fax:203-325-8566
Practice Address - Street 1:18 HILLANDALE AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2808
Practice Address - Country:US
Practice Address - Phone:203-327-9333
Practice Address - Fax:203-325-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0259192080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001259191Medicaid
NY00894808Medicaid