Healthcare Provider Details

I. General information

NPI: 1467668145
Provider Name (Legal Business Name): ANDREW JAMES TERRANELLA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W IRVINGTON RD BLDG 10
TUCSON AZ
85714-3050
US

IV. Provider business mailing address

2835 E 1ST ST
TUCSON AZ
85716-4102
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax:
Mailing address:
  • Phone: 989-528-0795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36965
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: