Healthcare Provider Details

I. General information

NPI: 1295137297
Provider Name (Legal Business Name): KATARINA JUHASZOVA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST SHEIKH ZAYED 1, ROOM 1085
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1830 E MONUMENT ST SUITE 6-100
BALTIMORE MD
21287-0020
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-2280
  • Fax: 410-955-0141
Mailing address:
  • Phone: 410-955-8708
  • Fax: 410-955-0141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0005494
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: