MEDICARE: DR. TIMOTHY ANDREW TEHAN PH.D.

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
1	103T00000X	Psychologist	PY3519	FL

General Provider Information

NPI Number	:	1255492989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY ANDREW TEHAN PH.D.

Provider Business Mailing Address
First Line	:	9521 INDALE DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9521 INDALE DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4322
Country	:	US
Telephone Number	:	727-862-7170
Fax Number	:	727-862-3870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/08/2007

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