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Contact Information

ANDRE A FEDIDA, MD
306 MARTIN LUTHER KING JR BLVD
4TH FLOOR
NEWARK, NJ07102-2011
 Phone: 973-877-2580
 Fax: 973-877-2578
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for ANDRE A FEDIDA · (Male)

NPI Number 1891839312
Status Active
Credentials MD
Entity Individual
Enumeration date 02/17/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # MA054073
  • NJ Medicaid 5049504
Hospital affiliation(s)
  • SAINT MICHAEL'S MEDICAL CENTER INC - (Acute Care)
    111 CENTRAL AVENUE
    NEWARK, NJ 07102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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