MEDICARE: DR. KATHERINE THERESA HRYNEWYCZ I MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	MD493443	PA
2	207N00000X	Dermatology Physician	MD493443	PA

General Provider Information

NPI Number	:	1407267115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE THERESA HRYNEWYCZ I MD

Provider Business Mailing Address
First Line	:	801 YORK ST
Second Line	:
City	:	MANITOWOC
State	:	WI
Zip	:	54220-4630
Country	:	US
Telephone Number	:	920-663-9008
Fax Number	:	920-684-1439

Provider Business Practice Location Address
First Line	:	2790 MOSSIDE BLVD STE 705
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-2743
Country	:	US
Telephone Number	:	412-372-2770
Fax Number	:	412-372-4656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	04/09/2026

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