Anderson, John A
Anderson, John A is an individual health care provider with primary practice located at 213 Broadway , Port Ewen NY 12466-7769. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, John A can be contacted via phone (845) 331-2355.Contact Information
Primary practice address
213 Broadway
Port Ewen NY 12466-7769
Phone: (845) 331-2355
Fax: (845) 331-1184
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 153823 | New York |
Profile Details
| NPI number | 1114972338 |
|---|---|
| LBN Legal business name | Anderson, John A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | Nov 11th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114972338 | NPPES |
| New York | MEDICAID | 00849270 |
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