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General NPI Number Information
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NPI Number | 1760694426
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Entity Type | Individual
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Provider Name | MR. TIMOTHY NORUM
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 210 SUMMIT AVE STE A1A
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City | MONTVALE
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State | NJ
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Zip | 07645-1579
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Country | US
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Telephone | 551-777-3502
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Fax | 201-746-9889
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Provider Business Mailing Address
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Address Line | 95 LINCOLN AVE
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City | PEARL RIVER
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State | NY
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Zip | 10965-1708
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Country | US
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Telephone | 551-777-3502
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Fax | 201-746-9889
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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