Individual
TARA LYNN TIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
184 E 70TH ST, SUITE B2, NEW YORK, NY 10021-5154
(212) 737-4174
(212) 737-3392
Mailing address
522 E 82ND ST, APT. #5, NEW YORK, NY 10028-7118
(212) 737-4174
(212) 737-3392
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
214284
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02193066
—
NY
Enumeration date
01/25/2006
Last updated
10/15/2014
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