Provider Demographics
NPI:1013779289
Name:NEIGHBORHOOD FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:NEIGHBORHOOD FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ENTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-770-9783
Mailing Address - Street 1:105 BARRINGTON RD. N.
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-0001
Mailing Address - Country:US
Mailing Address - Phone:919-557-0344
Mailing Address - Fax:
Practice Address - Street 1:105 BARRINGTON RD. N.
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-0001
Practice Address - Country:US
Practice Address - Phone:919-557-0344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty