Andrea Michelle Gaines

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

11 Laurel TRL
Sag Harbor, NY 11963-2409

Phone

(631) 899-3692

NPI assigned

Jul 23, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1275888562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LAUREL TRL",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119632409",
            "telephone_number": "631-899-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 LAUREL TRL",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119632409",
            "telephone_number": "631-899-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liliana Fazendeiro, PTA
• Emily Mara Feinberg, LMSW
• Fighting Chance, Inc
• Sinead Fitzgibbon, PT, PHD
• John Francis French Jr., DMD
• Glenn Neal Goodman, DC
• Tod Reed Granger, DDS
• Eva Greco, PSY.D.
• Julia Rose Greenberg, LMHC-T
• Susan S. Griffin, LCSW

• Specialist in Sag Harbor, NY
• Providers in Sag Harbor, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.