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NPI Code Detail

MEDICARE: MR. TIMOTHY TREMBLAY MSN

MEDICARE: MR. TIMOTHY TREMBLAY MSN
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
1163W00000XRegistered NurseRN287419OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0036256OH
3363L00000XNurse PractitionerAPRN.CNP.0036256OH

General Provider Information

NPI Number : 1598521767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY TREMBLAY MSN
Provider Business Mailing Address
First Line : 1980 TAMARACK RD
Second Line :
City : NEWARK
State : OH
Zip : 43055-1363
Country : US
Telephone Number : 220-564-7520
Fax Number : 220-564-7521
Provider Business Practice Location Address
First Line : 1320 W MAIN ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-3699
Country : US
Telephone Number : 220-564-4220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2024
Last Update Date : 01/06/2025

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