Provider Demographics
NPI:1972648541
Name:SPERO, TIMOTHY J (PHYSICAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:J
Last Name:SPERO
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Gender:M
Credentials:PHYSICAN ASSISTANT
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Mailing Address - Street 1:325 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EAST NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403
Mailing Address - Country:US
Mailing Address - Phone:610-272-1881
Mailing Address - Fax:610-275-8819
Practice Address - Street 1:325 WEST GERMANTOWN PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:EAST NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403
Practice Address - Country:US
Practice Address - Phone:610-272-1881
Practice Address - Fax:610-275-8819
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOA002140363A00000X
PAMA052806363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant