Provider Demographics
NPI:1598762171
Name:DOWD, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:DOWD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OVERLOOK RD STE 311
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3563
Mailing Address - Country:US
Mailing Address - Phone:908-598-1500
Mailing Address - Fax:908-598-0197
Practice Address - Street 1:33 OVERLOOK RD STE 311
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3563
Practice Address - Country:US
Practice Address - Phone:908-598-1500
Practice Address - Fax:908-598-0197
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08591800207L00000X
NY155488207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01130941Medicaid
NJ25MA08591800OtherNEW JERSEY STATE MEDICAL LICENSE
NY01130941Medicaid