Provider Demographics
NPI:1518774892
Name:ANDREANA, JOHN LORENZO
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LORENZO
Last Name:ANDREANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3747
Mailing Address - Country:US
Mailing Address - Phone:617-238-4789
Mailing Address - Fax:
Practice Address - Street 1:1304 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3747
Practice Address - Country:US
Practice Address - Phone:617-238-4789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor