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General NPI Number Information
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NPI Number | 1457187791
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Entity Type | Individual
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Provider Name | TIMOTHY J COBB
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Gender | Male
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 60 HOSPITAL RD
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City | LEOMINSTER
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State | MA
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Zip | 01453-2205
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Country | US
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Telephone | 978-466-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 HAZELWOOD WAY
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City | CLINTON
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State | MA
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Zip | 01510-3939
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Country | US
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Telephone | 978-799-6209
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LDN6945
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License Number State | MA
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