Provider Demographics
NPI:1730355892
Name:CHAMBERS, TIMOTHY MICHAEL (LAC, LMT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MICHAEL
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 MULBERRY ST
Mailing Address - Street 2:SUITE #13
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4131
Mailing Address - Country:US
Mailing Address - Phone:212-219-9880
Mailing Address - Fax:
Practice Address - Street 1:241 MULBERRY ST
Practice Address - Street 2:SUITE #13
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4131
Practice Address - Country:US
Practice Address - Phone:212-219-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003727171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist