Groth, Timothy D
Groth, Timothy D is an individual health care provider with primary practice located at 994 W Jericho Tpke Suite 104, Smithtown NY 11787-3235. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Groth, Timothy D can be contacted via phone (631) 543-1440.Contact Information
Primary practice address
994 W Jericho Tpke Suite 104
Smithtown NY 11787-3235
Phone: (631) 543-1440
Fax: (631) 543-1930
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 158610 | New York |
Profile Details
| NPI number | 1093742272 |
|---|---|
| LBN Legal business name | Groth, Timothy D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Jun 27th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093742272 | NPPES |
| New York | MEDICAID | 01491318 |
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