Provider Demographics
NPI:1942694989
Name:CARNEY, TIMOTHY
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:CARNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 SWARTHMORE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4553
Mailing Address - Country:US
Mailing Address - Phone:732-901-5500
Mailing Address - Fax:732-901-5020
Practice Address - Street 1:1970 SWARTHMORE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4553
Practice Address - Country:US
Practice Address - Phone:732-901-5500
Practice Address - Fax:732-901-5020
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0073900374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide