Timothy Gannon, PTA is a
Physical Therapy Assistant physician based in Somerset, New Jersey. Timothy Gannon is licensed to practice in New Jersey (license number 40QB00317700) and his current practice location is 380 Demott Ln, Somerset, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(800) 571-6511.
NPI number for Timothy Gannon is 1346705803 and his current mailing address is Po Box 991, Malaga, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346705803.
Physician's Profile
| Full Name | Timothy Gannon |
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| Gender | Male |
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| Speciality | Physical Therapy Assistant |
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| Location | 380 Demott Ln, Somerset, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346705803
- Provider Enumeration Date: 02/08/2019
- Last Update Date: 02/08/2019
Medical Identifiers
Medical identifiers for Timothy Gannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346705803 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 40QB00317700 (New Jersey) | Secondary |
| 225200000X | Physical Therapy Assistant | 40QB00317700 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy Gannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Timothy Gannon, PTA
Po Box 991,
Malaga, NJ 08328-0991
Ph: (865) 278-7578 | Timothy Gannon, PTA
380 Demott Ln,
Somerset, NJ 08873-2762
Ph: (800) 571-6511 |
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