Provider Demographics
NPI:1891877551
Name:DR. TIMOTHY J. MAGGS CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:DR. TIMOTHY J. MAGGS CHIROPRACTIC P.C.
Other - Org Name:CAPITAL DISTRICT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-393-6566
Mailing Address - Street 1:1462 ERIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002193-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1125Medicare PIN