Provider Demographics
NPI:1831402379
Name:VANORDEN, ANDREW THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:THOMAS
Last Name:VANORDEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2133
Mailing Address - Country:US
Mailing Address - Phone:973-650-6675
Mailing Address - Fax:
Practice Address - Street 1:127 UNION ST
Practice Address - Street 2:SUITE 107
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4478
Practice Address - Country:US
Practice Address - Phone:201-444-4447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01362500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist