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Individual

ANDREW RICHARD MCCULLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
23 HACKETT BLVD, ALBANY, NY 12208
(518) 262-3341
(518) 262-6660
Mailing address
711 TROY - SCHENECTADY RD, SUITE 203, LATHAM, NY 12110
(518) 782-3700
(518) 782-3799

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
194809
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01523642
NY
Enumeration date
09/07/2005
Last updated
04/08/2011
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