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Contact Information

TIMOTHY KOBA, ATC,CSCS,LMT,CMT
310 TAUGHANNOCK BVLD
SUITE 5A
ITHACA, NY14850
 Phone: 607-252-3500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for TIMOTHY KOBA · (Male)

NPI # 1578736799
Status Active
Credentials ATC,CSCS,LMT,CMT
Entity Individual
Enumeration date 04/09/2008
Last updated 04/10/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 001623-1
  • NY License # 019227
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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