Provider Demographics
NPI:1215995477
Name:PORROVECCHIO, ANDREA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:PORROVECCHIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:NW6
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-920-3822
Mailing Address - Fax:718-920-8375
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:NW6
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-3822
Practice Address - Fax:718-920-8375
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-05-18
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Provider Licenses
StateLicense IDTaxonomies
LA026753207R00000X
NY247831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine