Provider Demographics
NPI:1174599930
Name:DANDREA, ALAN DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:DAVID
Last Name:DANDREA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:24 CALUMET RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3535
Mailing Address - Country:US
Mailing Address - Phone:781-729-0898
Mailing Address - Fax:
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6084
Practice Address - Country:US
Practice Address - Phone:617-632-2112
Practice Address - Fax:617-632-5757
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA564132080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4147276OtherCIGNA
A59704DFOtherHPHC
2927580OtherAETNA US HEALTHCARE
MA3063518Medicaid
7504070OtherUNITED HEALTH CARE
056413OtherTUFTS
23285OtherFALLON HEALTH PLAN
7504070OtherUNITED HEALTH CARE
23285OtherFALLON HEALTH PLAN