Individual
DR. TIMOTHY CHARLES BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 MEDICAL CENTER DR, SUITE 162, STRATFORD, NJ 08084-1500
(856) 566-6708
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-7300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
291069
NY
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
291069
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2014
Last updated
11/02/2021
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