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
Fax: (845) 331-1184
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114972338 NPPES
New York MEDICAID 00849270

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