1396708335 NPI number — MS. CARYN ANDREWS CRNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396708335 NPI number — MS. CARYN ANDREWS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDREWS
Provider First Name:
CARYN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHEINBERG
Provider Other First Name:
CARYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396708335
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 W BELVEDERE AVE
Provider Second Line Business Mailing Address:
DEPT OF CREDENTIALING
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21215-5216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-601-5524
Provider Business Mailing Address Fax Number:
410-601-8946

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5401 OLD COURT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RANDALLSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21133-5103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-521-2200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  R144791 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CA8374 . This is a "R/R MEDICARE GROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 406044000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00689583 . This is a "R/R MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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