Provider Demographics
NPI:1407156128
Name:FIEN, TIMOTHY G (PT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:G
Last Name:FIEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1059
Mailing Address - Country:US
Mailing Address - Phone:856-649-5022
Mailing Address - Fax:856-547-0139
Practice Address - Street 1:123 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1059
Practice Address - Country:US
Practice Address - Phone:856-649-5022
Practice Address - Fax:856-547-0139
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00233700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist