Basic Information
| Provider Information | |||||||||
| NPI: | 1609118298 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ANDREA | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | RALPH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 95000 LB#7550 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191957550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443621735 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3175 STATE ROUTE 10 BLDG.C | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | DENVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013174590 | ||||||||
| FaxNumber: | 9733432134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2013 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA09769900 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.