Provider Demographics
NPI:1194418095
Name:DRUCKER, KATHRYN OLDHAM (PA)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:OLDHAM
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:OLDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:163 E 81ST ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1806
Mailing Address - Country:US
Mailing Address - Phone:336-970-0301
Mailing Address - Fax:
Practice Address - Street 1:440 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2143
Practice Address - Country:US
Practice Address - Phone:718-797-5504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical