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Individual
TIMOTHY C GJENVICK
Active
Individual
TIMOTHY C GJENVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03470600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085740000
AMERIHEALTH/IBC-PCP
NJ
01
—
110244288
RAILROAD MED.-MONROE
NJ
01
—
110246529
RAILROAD MED-PRINCETON
NJ
01
—
162296
AMERIHLTH ADMIN-PCP
NJ
01
—
249681
UNITEDE HEALTHCARE-PCP
NJ
01
—
2647154
AETNA HMO&NON HMO-PCP
NJ
05
—
3150305
—
NJ
01
—
LS403
OXFORD-PCP
NJ
Enumeration date
10/12/2006
Last updated
03/12/2008
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