Provider Demographics
NPI:1942494745
Name:ANDREW F DRAKE, D.O., P.A.
Entity type:Organization
Organization Name:ANDREW F DRAKE, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CASS
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-861-1702
Mailing Address - Street 1:838 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-2031
Mailing Address - Country:US
Mailing Address - Phone:609-861-1700
Mailing Address - Fax:609-861-2945
Practice Address - Street 1:838 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:NJ
Practice Address - Zip Code:08270-2031
Practice Address - Country:US
Practice Address - Phone:609-861-1700
Practice Address - Fax:609-861-2945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
157054Medicare PIN