Provider Demographics
NPI:1902813058
Name:ANDAYA, CECILIA ONG OH (MD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:ONG OH
Last Name:ANDAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221
Mailing Address - Country:US
Mailing Address - Phone:804-358-2361
Mailing Address - Fax:804-359-0949
Practice Address - Street 1:3603 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221
Practice Address - Country:US
Practice Address - Phone:804-358-2361
Practice Address - Fax:804-359-0949
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235863208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10011528OtherOPTIMA
VA183237OtherANTHEM
VA2137864OtherUNITED HEALTH CARE
VA60824OtherCARENET
VA010281750OtherVIRGINIA PREMIER
VA010281750Medicaid
VA320986OtherSOUTHERN HEALTH
VA4713318OtherCIGNA