Provider Demographics
NPI:1316293079
Name:OWENS, TIMOTHY J (OD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:OWENS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3013 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1526
Mailing Address - Country:US
Mailing Address - Phone:732-739-4000
Mailing Address - Fax:732-739-4002
Practice Address - Street 1:3013 HWY 35
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1526
Practice Address - Country:US
Practice Address - Phone:732-739-4000
Practice Address - Fax:732-739-4002
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00641100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316293079Medicare PIN