Provider Demographics
NPI:1003620154
Name:MCARDLE, TIMOTHY GEORGE (LMT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:GEORGE
Last Name:MCARDLE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 HURLEY AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2415
Mailing Address - Country:US
Mailing Address - Phone:845-389-0755
Mailing Address - Fax:845-331-3892
Practice Address - Street 1:211 HURLEY AVE STE 5
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2415
Practice Address - Country:US
Practice Address - Phone:845-389-0755
Practice Address - Fax:845-331-3892
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist