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NPI Code Detail

MEDICARE: TIMOTHY A. LEDEAN DO

MEDICARE: TIMOTHY A. LEDEAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083X0100XOccupational Medicine Physician20A8463CA
22083X0100XOccupational Medicine Physician077345CT

General Provider Information

NPI Number : 1093893570
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY A. LEDEAN DO
Provider Business Mailing Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4992
Fax Number : 860-679-3334
Provider Business Practice Location Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4992
Fax Number : 860-679-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/08/2024

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Directions to “ TIMOTHY A. LEDEAN DO” Practice Location

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