Provider Demographics
NPI:1962749432
Name:TIMPANO, EUGENE DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:DAVID
Last Name:TIMPANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3033
Mailing Address - Country:US
Mailing Address - Phone:856-786-2247
Mailing Address - Fax:856-786-2713
Practice Address - Street 1:1701 WYNWOOD DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3033
Practice Address - Country:US
Practice Address - Phone:856-786-2247
Practice Address - Fax:856-786-2713
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD00316300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery