Healthcare Provider Details

I. General information

NPI: 1457187734
Provider Name (Legal Business Name): SYDNEY TIMMERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 N 1ST ST
NEWARK OH
43055-5608
US

IV. Provider business mailing address

1158 SHARON VALLEY RD
NEWARK OH
43055-1762
US

V. Phone/Fax

Practice location:
  • Phone: 614-844-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: