Provider Demographics
NPI:1467491506
Name:DUER, TIMOTHY F (MSPT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:DUER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 ALMONESSON RD
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096
Mailing Address - Country:US
Mailing Address - Phone:856-345-1057
Mailing Address - Fax:856-345-1405
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:856-345-1057
Practice Address - Fax:856-345-1405
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01098600225100000X
DEJ1-0002548225100000X
PAPT024895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2288650000OtherAMERIHEALTH
NJ076308M6CMedicare ID - Type Unspecified