Timothy Olawale Balogun-Victor
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Secane, PA
NPI 1619201407 · NPPES record last updated Sep 25, 2009
Key facts
- NPI
- 1619201407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 151 S Bishop Ave
K20
Secane, PA 19018-1971 - Phone
- (610) 864-5660
- NPI assigned
- Sep 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
151 S Bishop Ave
K20
Secane, PA 19018-1971
Mailing address
151 S Bishop Ave
K20
Secane, PA 19018-1971
Phone (610) 864-5660
Other providers in Secane, PA
- Dennis Amoo Asare
- Wanda Ashby
- Teddy Asiedu-Akrofi
- Aidalan Bah
- Mamadou Malal Balde
- Pete J Bendig Jr.
- Veronica Brown
- Kadeah Burhannon
- Helena Katherine Bush
- Madeline Mary Byrne
All providers in Secane, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.