Provider Demographics
NPI:1679774574
Name:RASMUSSEN, ANDREW (PHD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:CD 733
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-994-7175
Mailing Address - Fax:212-994-7177
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:CD 733
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-994-7175
Practice Address - Fax:212-994-7177
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program