Provider Demographics
NPI:1174942759
Name:JOCHIM, ANDREA LAUREN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LAUREN
Last Name:JOCHIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 FORDHAM PLZ FL 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 FORDHAM PLZ FL 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5871
Practice Address - Country:US
Practice Address - Phone:718-933-2400
Practice Address - Fax:929-220-8077
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60771687207Q00000X
NY290720207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1174942759Medicaid
8967332OtherMEDICARE PIN