Provider Demographics
NPI:1457754046
Name:CURTIS, ANDREA LYNN (MS, PA-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:CURTIS
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Gender:F
Credentials:MS, PA-C
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Mailing Address - Street 1:4939 BRITTONFIELD PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9208
Mailing Address - Country:US
Mailing Address - Phone:315-634-6779
Mailing Address - Fax:315-634-6789
Practice Address - Street 1:4939 BRITTONFIELD PKWY STE 101
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9208
Practice Address - Country:US
Practice Address - Phone:315-634-6779
Practice Address - Fax:315-634-6789
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2017-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY018040-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04543606Medicaid
NYJ400333890Medicare PIN