Provider Demographics
NPI:1013954007
Name:TURRISI III, ANDREW T (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:T
Last Name:TURRISI III
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:PO BOX 515490
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-6790
Mailing Address - Country:US
Mailing Address - Phone:800-331-9294
Mailing Address - Fax:812-471-9282
Practice Address - Street 1:190 WELLES ST
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4968
Practice Address - Country:US
Practice Address - Phone:570-714-8686
Practice Address - Fax:570-714-8666
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010540322085R0001X
PAMD023476E2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP35120078Medicare PIN