Provider Demographics
NPI:1144658493
Name:MCGREGOR, ANDREA (CPNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 141ST ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2360
Mailing Address - Country:US
Mailing Address - Phone:646-852-1929
Mailing Address - Fax:
Practice Address - Street 1:1550 146TH ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3019
Practice Address - Country:US
Practice Address - Phone:646-852-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672155163W00000X
NY383197208000000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No208000000XAllopathic & Osteopathic PhysiciansPediatrics