Provider Demographics
NPI:1689764524
Name:WAECHTLER, CURTIS H (PHD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:H
Last Name:WAECHTLER
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 1:507 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1317
Mailing Address - Country:US
Mailing Address - Phone:610-617-3676
Mailing Address - Fax:
Practice Address - Street 1:2106 NEW RD
Practice Address - Street 2:SUITE F-3
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1046
Practice Address - Country:US
Practice Address - Phone:610-574-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100423300103G00000X
PAPS007930L103G00000X
DEB1-0000609103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist