Provider Demographics
NPI:1528032075
Name:CURTIS, WILLIAM H (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:CURTIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 KIRK LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2220
Mailing Address - Country:US
Mailing Address - Phone:610-892-0390
Mailing Address - Fax:
Practice Address - Street 1:1033 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2220
Practice Address - Country:US
Practice Address - Phone:610-892-0390
Practice Address - Fax:610-566-8816
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003079L103G00000X, 103T00000X
PA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
163014OtherBC BS
119375OtherMANAGED HEALTH NETWORK
119375OtherMANAGED HEALTH NETWORK
163014Medicare ID - Type Unspecified