Provider Demographics
NPI:1205447968
Name:TIMONY, KATELYNN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KATELYNN
Middle Name:MARIE
Last Name:TIMONY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:LB# 7550, P.O. BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:17 STATE RT 23 N
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1419
Practice Address - Country:US
Practice Address - Phone:973-827-7800
Practice Address - Fax:973-209-7855
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant