Provider Demographics
NPI:1124086657
Name:AINSLIE, TIMOTHY L (PT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:L
Last Name:AINSLIE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLDG 4 SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-896-4128
Mailing Address - Fax:609-896-0962
Practice Address - Street 1:389 WALL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1516
Practice Address - Country:US
Practice Address - Phone:609-683-5970
Practice Address - Fax:609-454-3432
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA013072002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ163970P35Medicare PIN