Provider Demographics
NPI:1649832791
Name:CUNNINGHAM, CURTIS WENGHONG-TAM
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:WENGHONG-TAM
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BELL ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2003
Mailing Address - Country:US
Mailing Address - Phone:978-882-2889
Mailing Address - Fax:
Practice Address - Street 1:5 BELL ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2003
Practice Address - Country:US
Practice Address - Phone:978-882-2889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician