Provider Demographics
NPI:1366889396
Name:FLORES, ANDREA ALEJANDRA (DC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ALEJANDRA
Last Name:FLORES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4848
Mailing Address - Country:US
Mailing Address - Phone:201-688-0498
Mailing Address - Fax:
Practice Address - Street 1:135 AVENUE B
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2037
Practice Address - Country:US
Practice Address - Phone:201-455-3008
Practice Address - Fax:201-455-3005
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00707800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor