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NPI Code Detail

MEDICARE: TIMOTHY WILLIAM O'BRIEN

MEDICARE:   TIMOTHY WILLIAM O'BRIEN
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
1376J00000XHomemaker

General Provider Information

NPI Number : 1477269850
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY WILLIAM O'BRIEN
Provider Business Mailing Address
First Line : 4141 W 145TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-2057
Country : US
Telephone Number : 216-509-5861
Fax Number :
Provider Business Practice Location Address
First Line : 4141 W 145TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-2057
Country : US
Telephone Number : 216-509-5861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2023
Last Update Date : 01/27/2023

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Directions to “ TIMOTHY WILLIAM O'BRIEN ” Practice Location

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