Provider Demographics
NPI:1205278157
Name:OAKES, TIMOTHY JOHN (FNP)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:OAKES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2400
Mailing Address - Fax:
Practice Address - Street 1:999 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3535
Practice Address - Country:US
Practice Address - Phone:718-277-8303
Practice Address - Fax:718-277-4795
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6617741163W00000X
NYF338532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04312658Medicaid
NY00695941Medicaid
NY331009Medicare Oscar/Certification
NY04312658Medicaid
NY571000Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331957Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY00695941Medicaid
NY331043Medicare Oscar/Certification
NY331946Medicare Oscar/Certification