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General NPI Number Information
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NPI Number | 1316169238
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Entity Type | Individual
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Provider Name | TIMOTHY O'CONNOR MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE BOX 655
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City | ROCHESTER
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State | NY
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Zip | 14642-8655
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Country | US
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Telephone | 585-341-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE BOX 655
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City | ROCHESTER
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State | NY
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Zip | 14642-8655
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Country | US
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Telephone | 585-341-3015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MT189123
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD436616
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 144070
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 268288
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License Number State | NY
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