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General NPI Number Information
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NPI Number | 1689764524
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Entity Type | Individual
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Provider Name | CURTIS H WAECHTLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2106 NEW RD SUITE F-3
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City | LINWOOD
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State | NJ
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Zip | 08221-1046
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Country | US
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Telephone | 610-574-3367
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Fax |
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Provider Business Mailing Address
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Address Line | 507 VALLEY VIEW RD
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City | MERION STATION
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State | PA
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Zip | 19066-1317
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Country | US
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Telephone | 610-617-3676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35S100423300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS007930L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | B1-0000609
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License Number State | DE
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