Healthcare Provider Details

I. General information

NPI: 1770765919
Provider Name (Legal Business Name): CURTIS A ALLOY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 WOLF ST 1ST FLOOR
PHILADELPHIA PA
19148-2912
US

IV. Provider business mailing address

132 S 10TH ST 480 MAIN BUILDING
PHILADELPHIA PA
19107-5244
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8900
  • Fax: 215-755-1850
Mailing address:
  • Phone: 215-955-8900
  • Fax: 215-955-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberLG005512L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: