Gregory, Timothy Richard

Gregory, Timothy Richard is an sole proprietor health care provider with primary practice located at 56 Front St , Port Jervis NY 12771-2415. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gregory, Timothy Richard can be contacted via phone (845) 858-3253.

Contact Information

Primary practice address
56 Front St Port Jervis NY 12771-2415
Phone: (845) 858-3253
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R043053 New York

Profile Details

NPI number 1083623177
LBN Legal business name Gregory, Timothy Richard
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 7th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083623177 NPPES
Other 475049000 MAGELLEN
Other 1032020 MAGELLEN
Other N63253 MAGELLEN
Other N63253 MAGELLEN
Other YS112 MAGELLEN
Other 164055 MAGELLEN
Other 1032020 MAGELLEN
Other 1032020 MAGELLEN
Other 7406375003 MAGELLEN
Other N63252 MAGELLEN
Other 0007782292 MAGELLEN
Other N63252 MAGELLEN

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