| Stephen M. Timchack, Psyd, P.c. | |
|
480 Pierce St Suite 119 Kingston PA 18704-5512 | |
| (570) 714-1981 | |
| Not Available |
| Full Name | Stephen M. Timchack, Psyd, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 480 Pierce St, Kingston, Pennsylvania |
| Authorized Official Name and Position | Stephen M Timchack (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 5707141981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen M. Timchack, Psyd, P.c. 480 Pierce St Suite 119 Kingston PA 18704-5512 Ph: (570) 714-1981 | Stephen M. Timchack, Psyd, P.c. 480 Pierce St Suite 119 Kingston PA 18704-5512 Ph: (570) 714-1981 |
| NPI Number | 1699034934 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 05/07/2012 |
| Medicare PECOS PAC ID | 0840431417 |
|---|---|
| Medicare Enrollment ID | O20130724000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699034934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS016722 (Pennsylvania) | Primary |
| Provider Name | Stephen M Timchack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023281557 PECOS PAC ID: 2769646801 Enrollment ID: I20120621000127 |
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