Provider Demographics
NPI:1932200466
Name:NYCE, ANDREW L (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:NYCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERSITY EMERGENY PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2351
Practice Address - Fax:856-968-8272
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66622207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3551676OtherAETNA
NJ4366691OtherCIGNA
NJ60005653OtherHORIZON NJ HEALTH
NJP3385891OtherOXFORD
NJ2017545OtherUNITED HEALTHCARE
NJ263544OtherAMERIHEALTH PPO/PA BS
NJ0291836000OtherAMERIHEALTH/KEYSTONE/IBC
NJ010006324 00OtherAMERICHOICE
NJ222218OtherUNIVERSITY HEALTH PLAN
NJ7949006Medicaid
NJ222218OtherUNIVERSITY HEALTH PLAN
NJ7949006Medicaid
NJ027414 SZFMedicare PIN