Healthcare Provider Details

I. General information

NPI: 1801152004
Provider Name (Legal Business Name): ANDREW JOSEPH DEGNAN MD, MPHIL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E ERIE AVE
PHILADELPHIA PA
19134-1011
US

IV. Provider business mailing address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5234
  • Fax:
Mailing address:
  • Phone: 412-692-5515
  • Fax: 412-864-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD460620
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD460620
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: