Basic Information
| Provider Information | |||||||||
| NPI: | 1699098806 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | PHARM.D. M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636256 | ||||||||
| Address2: | CENTRAL CREDENTIALING | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132453104 | ||||||||
| FaxNumber: | 5135855511 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185838499 | ||||||||
| FaxNumber: | 5185804248 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2010 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35130708 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 293771 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.