Healthcare Provider Details

I. General information

NPI: 1710195391
Provider Name (Legal Business Name): TIMUR C AKINLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 E ROUTE 70
MARLTON NJ
08053-2341
US

IV. Provider business mailing address

765 E ROUTE 70
MARLTON NJ
08053-2341
US

V. Phone/Fax

Practice location:
  • Phone: 856-355-8883
  • Fax:
Mailing address:
  • Phone: 856-355-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2011-00679
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2011-00679
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: