Provider Demographics
NPI:1366512345
Name:TIMAR, ANDREW NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NICHOLAS
Last Name:TIMAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2676
Mailing Address - Country:US
Mailing Address - Phone:484-924-8548
Mailing Address - Fax:484-924-9748
Practice Address - Street 1:1220 VALLEY FORGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2676
Practice Address - Country:US
Practice Address - Phone:484-924-8548
Practice Address - Fax:484-924-9748
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814295743OtherTAX ID
PA3557468Medicare UPIN