MEDICARE: DR. OLGA A. KATZ M.D., PH.D.

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	2084N0400X	Neurology Physician	MD418729	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2958654	OTHER		AETNA HMO
2	7548362	OTHER		AETNA PPO
3	2075815000	OTHER	PA	KEYSTONE
4	1385814	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1427050913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLGA A. KATZ M.D., PH.D.

Provider Business Mailing Address
First Line	:	822 PINE ST
Second Line	:	SUITE 1 C
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-6187
Country	:	US
Telephone Number	:	215-574-3573
Fax Number	:	215-574-3645

Provider Business Practice Location Address
First Line	:	822 PINE ST
Second Line	:	SUITE C
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-6187
Country	:	US
Telephone Number	:	215-574-3573
Fax Number	:	215-574-3645

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	09/24/2009

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Directions to “ DR. OLGA A. KATZ M.D., PH.D.” Practice Location

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