Provider Demographics
NPI:1477715407
Name:ANDOLINO, DAVID LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEONARD
Last Name:ANDOLINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 RIVERSIDE CIR
Mailing Address - Street 2:RADIATION ONCOLOGY
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5671
Mailing Address - Country:US
Mailing Address - Phone:484-503-4400
Mailing Address - Fax:
Practice Address - Street 1:1600 RIVERSIDE CIR
Practice Address - Street 2:RADIATION ONCOLOGY
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5671
Practice Address - Country:US
Practice Address - Phone:484-503-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4452492085R0001X
NJ25MA091485002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology