Provider Demographics
NPI:1669448213
Name:ROWE, TIMOTHY OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:OWEN
Last Name:ROWE
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 1:50 BUCKSHOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MOHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3713
Mailing Address - Country:US
Mailing Address - Phone:845-621-8502
Mailing Address - Fax:845-628-9597
Practice Address - Street 1:10 MCMAHON PLACE
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3713
Practice Address - Country:US
Practice Address - Phone:845-621-8502
Practice Address - Fax:845-628-9597
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0315362084P0802X
NY1734922084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01649870Medicaid
NY01649870Medicaid
B99382Medicare UPIN
NY01420795Medicaid
NY12L601Medicare ID - Type Unspecified