Provider Demographics
NPI:1336514397
Name:CURCURU, ANTHONY (PNP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CURCURU
Suffix:
Gender:M
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ANDOVER PEDIATRICS
Mailing Address - Street 2:203 TURNPIKE ST, SUITE 200
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-475-4522
Mailing Address - Fax:978-688-6047
Practice Address - Street 1:ANDOVER PEDIATRICS
Practice Address - Street 2:203 TURNPIKE ST, SUITE 200
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-475-4522
Practice Address - Fax:978-688-6047
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2284857363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110152519AMedicaid