Provider Demographics
NPI:1558990978
Name:DILLON, KATHERINE ROSE (DO)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE
Last Name:DILLON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 11TH ST STE 8290
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4824
Mailing Address - Country:US
Mailing Address - Phone:215-955-2370
Mailing Address - Fax:215-955-0677
Practice Address - Street 1:175 MADISON AVENUE, 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:MT. HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060
Practice Address - Country:US
Practice Address - Phone:609-914-6000
Practice Address - Fax:609-914-6296
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB12131700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty