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NPI Code Detail

MEDICARE: DR. TIMOTHY P O'CONNOR MD

MEDICARE: DR. TIMOTHY P O'CONNOR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist36076MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124095997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY P O'CONNOR MD
Provider Business Mailing Address
First Line : 2014 WASHINGTON ST
Second Line : VERNON CANCER CENTER
City : NEWTON
State : MA
Zip : 02462-1607
Country : US
Telephone Number : 617-658-6000
Fax Number : 617-658-6001
Provider Business Practice Location Address
First Line : 2014 WASHINGTON ST
Second Line : VERNON CANCER CENTER
City : NEWTON
State : MA
Zip : 02462-1607
Country : US
Telephone Number : 617-658-6000
Fax Number : 617-658-6001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 10/19/2009

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