Provider Demographics
NPI:1801465323
Name:ANDERSON, DREW SAMANTHA (NBC-HWC)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:SAMANTHA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 RUGBY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6505
Mailing Address - Country:US
Mailing Address - Phone:201-970-1595
Mailing Address - Fax:
Practice Address - Street 1:523 RUGBY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6505
Practice Address - Country:US
Practice Address - Phone:201-970-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date: