MEDICARE: DR. BRIAN A TIMKO M.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	208M00000X	Hospitalist Physician	CT039758	CT

General Provider Information

NPI Number	:	1659352946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN A TIMKO M.D.

Provider Business Mailing Address
First Line	:	1 HOSPITAL PLZ
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-3602
Country	:	US
Telephone Number	:	203-276-7298
Fax Number	:	203-276-4842

Provider Business Practice Location Address
First Line	:	1 HOSPITAL PLZ
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-3602
Country	:	US
Telephone Number	:	203-276-7298
Fax Number	:	203-276-4842

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	04/16/2024

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