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General NPI Number Information
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NPI Number | 1760429260
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Entity Type | Organization
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Legal Business Name | EUGENE ANDRUCZYK, D.O., LLC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9501 ROOSEVELT BLVD SUITE 404
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1025
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Country | US
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Telephone | 215-676-3280
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Fax | 215-567-3821
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Provider Business Mailing Address
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Address Line | 9501 ROOSEVELT BOULEVARD SUITE 404
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1029
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Country | US
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Telephone | 215-676-3280
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Fax | 215-567-3821
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE ANDRUCZYK
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Credential | D.O.
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Telephone | 215-676-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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