Timothy John Ciolkosz, DC
Individual provider Active NPI Chiropractor · Wilmington, DE
NPI 1013987221 · NPPES record last updated Oct 10, 2012
Key facts
- NPI
- 1013987221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- F1 0000424 (DE)
- Practice address
- 3105 Limestone Rd
Suite303
Wilmington, DE 19808-2147 - Phone
- (302) 993-9113
- Fax
- (302) 993-0313
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100527000756 | DE | Practitioner - Chiropractic | 8527073204 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F1 0000424 | DE | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Chiropractic Office, P.a. | Chiropractor | Current |
Accepting new patients |
Locations
4748 Limestone Rd
Ste B
Wilmington, DE 19808
Phone (302) 993-9113
3105 Limestone Rd
Ste 303
Wilmington, DE 19808
Phone (302) 993-9113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | F1 0000424 | DE | Yes |
Addresses
Primary practice location
3105 Limestone Rd
Suite303
Wilmington, DE 19808-2147
Mailing address
3105 Limestone Rd
Suite 303
Wilmington, DE 19808-2147
Phone (302) 993-9113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 522088872 | Other | DE | BCBS |
| 1040507 | Other | DE | AETNA |
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.