Provider Demographics
NPI:1649277963
Name:CLADER, TIMOTHY J (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:CLADER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 HAGEN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2657
Mailing Address - Country:US
Mailing Address - Phone:585-218-9651
Mailing Address - Fax:585-267-4037
Practice Address - Street 1:20 HAGEN DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2657
Practice Address - Country:US
Practice Address - Phone:585-218-9651
Practice Address - Fax:585-267-4037
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-04-27
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Provider Licenses
StateLicense IDTaxonomies
NY154267207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB72487Medicare UPIN