Provider Demographics
NPI:1588722847
Name:SIKORYAK, KATHERINE HOLLY (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:HOLLY
Last Name:SIKORYAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 RICHMOND HWY
Mailing Address - Street 2:#415
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2300
Mailing Address - Country:US
Mailing Address - Phone:703-704-6346
Mailing Address - Fax:703-704-6687
Practice Address - Street 1:8350 RICHMOND HWY
Practice Address - Street 2:#415
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2300
Practice Address - Country:US
Practice Address - Phone:703-704-6346
Practice Address - Fax:703-704-6687
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00401832084P0800X
DCMD0385002084P0804X
VA01010454712084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD308091900Medicaid
VAUNKNOWNMedicaid