Provider Demographics
NPI:1831117845
Name:MAGGS, TIMOTHY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:MAGGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SWAGGERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-3225
Mailing Address - Country:US
Mailing Address - Phone:518-393-6566
Mailing Address - Fax:518-393-2616
Practice Address - Street 1:1462 ERIE BLVD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-1026
Practice Address - Country:US
Practice Address - Phone:518-393-6566
Practice Address - Fax:518-393-2616
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002193-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26532Medicare UPIN
NYAA1125Medicare ID - Type Unspecified