O'Leary, Timothy Joseph

O'Leary, Timothy Joseph is an sole proprietor health care provider with primary practice located at 4292 Lake Ave , Rochester NY 14612-4808. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. O'Leary, Timothy Joseph can be contacted via phone (585) 663-3957.

Contact Information

Primary practice address
4292 Lake Ave Rochester NY 14612-4808
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 038370 New York

Profile Details

NPI number 1699831453
LBN Legal business name O'Leary, Timothy Joseph
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2006
Last updated Jul 9th, 2007 - about 17 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699831453 NPPES
New York Other 7438 ROCHESTER BLUE SHIELD ID
New York MEDICAID 00843852 ROCHESTER BLUE SHIELD ID

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