Provider Demographics
NPI:1659371862
Name:MCGRATH, TIMOTHY V (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:V
Last Name:MCGRATH
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 1:3 GATES CIR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1120
Mailing Address - Country:US
Mailing Address - Phone:716-887-4040
Mailing Address - Fax:716-887-5090
Practice Address - Street 1:3925 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1738
Practice Address - Country:US
Practice Address - Phone:716-250-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236504207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY236504OtherNEW YORK STATE WORKERS COMPENSATION
NY02683796Medicaid
NY0912967OtherINDEPENDENT HEALTH
NY00027260801OtherUNIVERA
NY000528889001OtherBLUE CROSS AND BLUE SHIELD
NY236504OtherNEW YORK STATE WORKERS COMPENSATION
NYI45379Medicare UPIN
NYRA8569Medicare PIN