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NPI Code Detail

MEDICARE: TIMOTHY LEONARD PROBE DC

MEDICARE: TIMOTHY LEONARD PROBE DC
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
1111N00000XChiropractor38MC00269500NJ

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 : 1275516247
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY LEONARD PROBE DC
Provider Business Mailing Address
First Line : 5 SPRINGHILL RD
Second Line :
City : MANTUA
State : NJ
Zip : 08051-1601
Country : US
Telephone Number : 856-853-1114
Fax Number : 856-845-1881
Provider Business Practice Location Address
First Line : 740 MANTUA PIKE
Second Line :
City : WOODBURY HEIGHTS
State : NJ
Zip : 08097-1149
Country : US
Telephone Number : 856-845-0360
Fax Number : 856-845-1881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 09/27/2011

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Directions to “ TIMOTHY LEONARD PROBE DC” Practice Location

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