MEDICARE: DR. EUGENE VINCENT TIMPANO DPM

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
1	213ES0131X	Foot Surgery Podiatrist	MDO1381	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508866427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE VINCENT TIMPANO DPM

Provider Business Mailing Address
First Line	:	1701 WYNNWOOD DR
Second Line	:	SUITE 4
City	:	CINNAMINSON
State	:	NJ
Zip	:	08077-3033
Country	:	US
Telephone Number	:	856-786-2247
Fax Number	:	856-786-2713

Provider Business Practice Location Address
First Line	:	1701 WYNNWOOD DR
Second Line	:	SUITE 4
City	:	CINNAMINSON
State	:	NJ
Zip	:	08077-3033
Country	:	US
Telephone Number	:	856-786-2247
Fax Number	:	856-786-2713

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	09/12/2007

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