Provider Demographics
NPI:1295057081
Name:TIMKO, CATHERINE ALIX (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ALIX
Last Name:TIMKO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:C.
Other - Middle Name:ALIX
Other - Last Name:TIMKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:ROBERT'S CENTER FOR PEDIATRIC RESEARCH
Mailing Address - Street 2:2716 SOUTH STREET, 8-212
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:267-426-5467
Mailing Address - Fax:
Practice Address - Street 1:100 W 6TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2428
Practice Address - Country:US
Practice Address - Phone:610-883-7492
Practice Address - Fax:610-566-0179
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04423103TC0700X
PAPS016132103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical