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NPI Code Detail

MEDICARE: DR. TIMOTHY O'BYRNE MD

MEDICARE: DR. TIMOTHY O'BYRNE MD
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
1207RC0000XCardiovascular Disease Physician194645NY

Other Identifiers

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

General Provider Information

NPI Number : 1538144514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY O'BYRNE MD
Provider Business Mailing Address
First Line : 501 SEAVIEW AVE
Second Line : SUITE 100
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-667-0077
Fax Number : 718-667-4103
Provider Business Practice Location Address
First Line : 501 SEAVIEW AVE
Second Line : SUITE 100
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-667-0077
Fax Number : 718-667-4103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 05/15/2026

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