DR. TIMOTHY THOMAS SHACK (NPI# 1821273616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821273616 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY THOMAS SHACK |
| Credential | M.D. |
| Practice Address |
27 Covered Bridge Rd Cherry Hill NJ 08034-2945 |
| Practice Telephone | 8564292224 |
| Practice Fax Number | 8564291926 |
| Mailing Telephone | 8564292224 |
| Mailing Fax Number | 8564291926 |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2012-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD064207L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
27 COVERED BRIDGE RD |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08034-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962490243 | Anthony S Jennings | Internal Medicine | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2005-10-11 |
| 1386257509 | Brittany Lauren Chittum | Hospitalist | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2020-08-27 |
| 1740802461 | Laura Lyn Barrett | Nurse Practitioner | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2020-05-15 |
| 1760014294 | Joseph William Lever | Nurse Practitioner | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2020-02-12 |
| 1376107839 | Nicole Marie Kordziel | Registered Nurse | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2019-04-30 |
| 1568933125 | Kelley Tasca-fiorelli | Nurse Practitioner | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2018-12-07 |
| 1366821712 | Michelle Crass | Nurse Practitioner | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2015-05-19 |
| 1801087671 | Kimberly Irene Rozengarten | Internal Medicine | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2007-08-07 |
| 1972668358 | John Anthony Mazzochette | Psychiatry & Neurology | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2006-12-26 |
| 1346284213 | Robert J Maro Jr. | Internal Medicine | 27 Covered Bridge Rd, Cherry Hill, NJ 08034-2945 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821606054 | Glickman Psychological Services, LLC | Psychologist | 80 Barclay Center, Suite 4, Cherry Hill, NJ 08034 | 2020-07-14 |
| 1215455225 | Arc of Camden County Millhurst Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 141 Hayes Mill Road, Apt 218, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1144748120 | Arc of Camden County Chanticleer Drive Supported Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 712 Chanticleer Drive, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1124558689 | 1 Choice Home Health Care, LLC | Home Health | 1409 E. Highway 70, Barclay Pavilion, Suite 207w, Cherry Hill, NJ 08034 | 2017-06-18 |
| 1205362621 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 Wayland Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1598291940 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Brookdale Dr, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1861928285 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Portsmouth Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1265967954 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Farmhouse Ln, Maple Shade, NJ 08034 | 2017-05-01 |
| 1023543709 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 407 Cranford Rd, Cherry Hill, NJ 08034 | 2017-05-01 |
| 1588199269 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Colgate Drive, Cherry Hill, NJ 08034 | 2017-05-01 |
| Find all providers in zip 08034 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942757612 | Steven Ockrymiek | Internal Medicine | 25 Cohasset Ln, Cherry Hill, NJ 08003-1934 | 2016-09-09 |
| 1669847646 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 2211 Chapel Ave West, Ste 301, Cherry Hill, NJ 08002 | 2015-12-02 |
| 1659764025 | Rachel Jenna Masel-miller | Internal Medicine | 1210 Brace Rd Ste 102, Cherry Hill, NJ 08034 | 2015-03-10 |
| 1154727303 | Premier Physician Network, LLC | Internal Medicine | 1415 Marlton Pike E Ste Ll5, Cherry Hill, NJ 08034-2229 | 2014-11-17 |
| 1932538451 | Irene Felecidad Kirkland | Internal Medicine | 10 Partridge Ct, Cherry Hill, NJ 08003-2202 | 2013-11-05 |
| 1851738819 | Daniel A Baik | Internal Medicine | 2339 Route 70 W, Cherry Hill, NJ 08002-3315 | 2013-05-31 |
| 1659613347 | Marissa Naomi Karpoff | Internal Medicine | 1935 Route 70 E Fl 2, Cherry Hill, NJ 08003 | 2013-03-20 |
| 1003059866 | Shagufta Ahsan | Internal Medicine | 71 Lafayette Ln, Cherry Hill, NJ 08003-2535 | 2009-04-09 |
| 1790920577 | Jacques Abi Rached | Internal Medicine | 207 Kings Hwy S Ste 2, Cherry Hill, NJ 08034-2508 | 2008-12-09 |
| 1003090275 | Alexandr Zaslavsky | Internal Medicine | 2171 Route 70 W, Cherry Hill, NJ 08002-2733 | 2007-12-24 |
| Find all providers in CHERRY HILL | ||||
| City | CHERRY HILL |
| Zip Code | 08034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.