Provider Demographics
NPI:1538984307
Name:TESTER, ANDRE BRIAN
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:BRIAN
Last Name:TESTER
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 1:2055 CALLE AMATISTA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5112
Mailing Address - Country:US
Mailing Address - Phone:787-242-8008
Mailing Address - Fax:
Practice Address - Street 1:1 AVE WALL
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1649
Practice Address - Country:US
Practice Address - Phone:787-221-0874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst