Individual
TIMOTHY LARSON PURCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
162 GARDEN AVE, PARAMUS, NJ 07652-1937
(201) 401-0859
(888) 568-4217
Mailing address
162 GARDEN AVE, PARAMUS, NJ 07652-1937
(201) 401-0859
(888) 568-4217
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA00794600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750390787
—
NJ
Enumeration date
08/07/2006
Last updated
11/13/2018
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