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Individual

MR. ANDREW WALTER DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA-C

Contact information

Practice address
3RD AVE AND 183RD STR, BRONX, NY 10457-2594
(718) 960-9000
Mailing address
304 W 148TH ST, APT 2A, NEW YORK, NY 10039-2915
(570) 660-7085

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
011617
NY

Other

Enumeration date
12/26/2006
Last updated
07/08/2007
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