Provider Demographics
NPI:1598596140
Name:MCGEE, TIMICKA
Entity type:Individual
Prefix:
First Name:TIMICKA
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TOWN SQUARE PL STE 1238
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1810
Mailing Address - Country:US
Mailing Address - Phone:856-409-3170
Mailing Address - Fax:
Practice Address - Street 1:111 TOWN SQUARE PL STE 1238
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1810
Practice Address - Country:US
Practice Address - Phone:856-409-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ451135278251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health