Provider Demographics
NPI:1396284915
Name:ANDREA EGERT LLC
Entity type:Organization
Organization Name:ANDREA EGERT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-323-6165
Mailing Address - Street 1:322 MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1420
Mailing Address - Country:US
Mailing Address - Phone:845-323-6165
Mailing Address - Fax:
Practice Address - Street 1:322 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1420
Practice Address - Country:US
Practice Address - Phone:845-323-6165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health