Provider Demographics
NPI:1215975578
Name:LARKIN, TIMOTHY JAMES (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JAMES
Last Name:LARKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HERRICK ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5900
Mailing Address - Country:US
Mailing Address - Phone:978-927-8400
Mailing Address - Fax:978-922-1452
Practice Address - Street 1:75 HERRICK ST. SUITE 206
Practice Address - Street 2:LAHEY CARDIOLOGY, BEVERLY
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5900
Practice Address - Country:US
Practice Address - Phone:978-927-8400
Practice Address - Fax:978-922-1452
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078369207RI0011X
MA279224207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036078369Medicaid
060063131OtherRAILROAD MEDICARE
IL636420Medicare ID - Type Unspecified
IL200251012Medicare PIN
060063131OtherRAILROAD MEDICARE
IL575080004Medicare PIN