Basic Information
| Provider Information | |||||||||
| NPI: | 1174799944 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 64 BLEECKER ST # 151 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100122410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023131584 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 64 BLEECKER ST # 151 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100122410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023131584 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2008 | ||||||||
| LastUpdateDate: | 02/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DR.55071 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 265062 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 1.055403 | CT | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD042785 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME130291 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 36138997 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 01076738A | IN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 101260142 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4301110449 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2016-01630 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 25MA09870700 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 35.129569 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD457790 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A110180 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 278153 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.