Healthcare Provider Details

I. General information

NPI: 1174579973
Provider Name (Legal Business Name): ANDREW JOSEPH CURTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 GRANT AVE
PHILADELPHIA PA
19115-3167
US

IV. Provider business mailing address

101 GREENWOOD AVE
JENKINTOWN PA
19046-2627
US

V. Phone/Fax

Practice location:
  • Phone: 215-934-6100
  • Fax:
Mailing address:
  • Phone: 215-379-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD032885E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number25MA08755700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC1-0009494
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: