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NPI Code Detail

MEDICARE: MR. TIMOTHY PATRICK GRIFFIN PT

MEDICARE:  MR. TIMOTHY PATRICK GRIFFIN  PT
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
12251E1200XErgonomics Physical Therapist1430ME
22251S0007XSports Physical Therapist1430ME
32251X0800XOrthopedic Physical Therapist1430ME

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000459401OTHERMEMEDICARE PTAN

General Provider Information

NPI Number : 1477738391
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY PATRICK GRIFFIN PT
Provider Business Mailing Address
First Line : 73 NEWTON RD
Second Line : SUITE 101
City : PLAISTOW
State : NH
Zip : 03865-2424
Country : US
Telephone Number : 978-388-7272
Fax Number : 978-388-7373
Provider Business Practice Location Address
First Line : 50 SEWALL ST
Second Line : SUITE 101
City : PORTLAND
State : ME
Zip : 04102-2645
Country : US
Telephone Number : 207-772-7662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2008
Last Update Date : 06/25/2015

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Directions to “ MR. TIMOTHY PATRICK GRIFFIN PT” Practice Location

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