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General NPI Number Information
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NPI Number | 1902155369
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Entity Type | Organization
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Legal Business Name | TIMOTHY GEORGE M.D., P.C.
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 239 HIGBIE LANE
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City | WEST ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-376-6000
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Fax | 631-376-6031
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Provider Business Mailing Address
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Address Line | 239 HIGBIE LANE
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City | WEST ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-376-6000
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Fax | 631-376-6031
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY GEORGE
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Credential | M.D.
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Telephone | 631-376-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 198209
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License Number State | NY
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