Provider Demographics
NPI:1447514278
Name:MAJAK, ANDREW REILLY (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:REILLY
Last Name:MAJAK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 WASHINGTON ST 2
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3672
Mailing Address - Country:US
Mailing Address - Phone:315-782-4800
Mailing Address - Fax:315-788-6835
Practice Address - Street 1:513 WASHINGTON ST 2
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3672
Practice Address - Country:US
Practice Address - Phone:315-782-4800
Practice Address - Fax:315-788-6835
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYSN006678-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery