Individual
MR. TIMOTHY GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
76 WILLOWBROOK BLVD, WAYNE, NJ 07470-7002
(862) 246-7938
Mailing address
76 WILLOWBROOK BLVD, WAYNE, NJ 07470-7002
(862) 246-7938
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00560000
NJ
Other
Enumeration date
04/13/2017
Last updated
05/19/2020
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