Provider Demographics
NPI:1235662750
Name:MCCOY, ANDREW RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RICHARD
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:CSH #231
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-7439
Mailing Address - Fax:267-426-5236
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CSH #231
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-7439
Practice Address - Fax:267-426-5236
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4812442081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine