| Doctor Name: | MR. TIMOTHY S PEDERSEN |
| NPI Number: | 1114004231 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, PT |
| License Number: | PT01872 |
| Business Practice Address: | 17 Sarahs Way Fairhaven, MA - 027193161 |
| Business Phone Number: | 5089912918 |
| Business Fax Number: | 5089943068 |
| Mailing Address: | 17 Sarahs Way, FAIRHAVEN |
| State: | MA |
| Postal Code: | 027193161 |
| Phone Number: | 5089912918 |
| Fax Number: | 5089943068 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 09/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT01872 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |