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1689108987
TIMOTHY GODFREY
WAYNE, NJ
NPI
1689108987
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NJ 25MP00560000)
Enumeration Date
2017-04-13
Last Update Date
2020-05-19
Business Address
Mr. TIMOTHY GODFREY PA
76 WILLOWBROOK BLVD
WAYNE, NJ 07470-7002
Phone number: 862-246-7938
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Mailing Address
Mr. TIMOTHY GODFREY PA
76 WILLOWBROOK BLVD
WAYNE, NJ 07470-7002
Phone number: 862-246-7938
Copy
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