Provider Demographics
NPI:1386887594
Name:DODELZON, KATERINA (MD)
Entity type:Individual
Prefix:DR
First Name:KATERINA
Middle Name:
Last Name:DODELZON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:575 LEXINGTON AVE RM 540
Mailing Address - Street 2:NEWYORK-PRESBYTERIAN-WEILL CORNELL MEDICAL COLLEGE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6145
Mailing Address - Country:US
Mailing Address - Phone:212-746-6000
Mailing Address - Fax:646-962-0122
Practice Address - Street 1:525 E 68TH ST # 141
Practice Address - Street 2:NEWYORK-PRESBYTERIAN-WEILL CORNELL MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-6000
Practice Address - Fax:646-962-0122
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2538542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program