Provider Demographics
NPI:1811288715
Name:HARRIGAN, TIMOTHY (PA)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:HARRIGAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 MCCLELLAN ST
Mailing Address - Street 2:2W
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1009
Mailing Address - Country:US
Mailing Address - Phone:518-347-5400
Mailing Address - Fax:518-347-5222
Practice Address - Street 1:1101 NOTT ST
Practice Address - Street 2:B6
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2425
Practice Address - Country:US
Practice Address - Phone:518-243-3387
Practice Address - Fax:518-831-8100
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY014872363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant