MEDICARE: DR. TIMOTHY JOEL GARRAND 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
1	207RC0000X	Cardiovascular Disease Physician	1641201	NY

General Provider Information

NPI Number	:	1326041989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY JOEL GARRAND MD

Provider Business Mailing Address
First Line	:	210 CORNELIA ST
Second Line	:	STE 101
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2318
Country	:	US
Telephone Number	:	518-562-7990
Fax Number	:	518-562-7991

Provider Business Practice Location Address
First Line	:	210 CORNELIA ST
Second Line	:	STE 101
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2318
Country	:	US
Telephone Number	:	518-562-7990
Fax Number	:	518-562-7991

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/03/2011

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