Healthcare Provider Details

I. General information

NPI: 1942297080
Provider Name (Legal Business Name): PATRICK F TIMMINS III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S MANNING BLVD SUITE 301
ALBANY NY
12208-1742
US

IV. Provider business mailing address

319 S MANNING BLVD SUITE 301
ALBANY NY
12208-1742
US

V. Phone/Fax

Practice location:
  • Phone: 518-458-1390
  • Fax: 518-459-3271
Mailing address:
  • Phone: 518-458-1390
  • Fax: 518-459-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number202700
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: