Provider Demographics
NPI:1427050913
Name:KATZ, OLGA A (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:A
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 PINE ST
Mailing Address - Street 2:SUITE 1 C
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6187
Mailing Address - Country:US
Mailing Address - Phone:215-574-3573
Mailing Address - Fax:215-574-3645
Practice Address - Street 1:822 PINE ST
Practice Address - Street 2:SUITE C
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6187
Practice Address - Country:US
Practice Address - Phone:215-574-3573
Practice Address - Fax:215-574-3645
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4187292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2958654OtherAETNA HMO
7548362OtherAETNA PPO
PA2075815000OtherKEYSTONE
PA1385814OtherHIGHMARK
2958654OtherAETNA HMO
PA055429YXEMedicare PIN