Provider Demographics
NPI:1437548997
Name:CUMMINS, ANDREW S
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:CUMMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:S
Other - Last Name:CUMMINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:34 FERRIS AVE
Mailing Address - Street 2:UNIT A1
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-1581
Mailing Address - Country:US
Mailing Address - Phone:309-229-4659
Mailing Address - Fax:
Practice Address - Street 1:260 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4804
Practice Address - Country:US
Practice Address - Phone:203-916-4600
Practice Address - Fax:203-916-4601
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000537175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath