Provider Demographics
NPI:1629831169
Name:TIMOTHEOU, MARIA CHRISANTHE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISANTHE
Last Name:TIMOTHEOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 MANETTE LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-1827
Mailing Address - Country:US
Mailing Address - Phone:845-270-0311
Mailing Address - Fax:
Practice Address - Street 1:717 MANETTE LN
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-1827
Practice Address - Country:US
Practice Address - Phone:845-270-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered