Healthcare Provider Details

I. General information

NPI: 1023148228
Provider Name (Legal Business Name): KATHRYN ELIZABETH ITALIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN E MULLER MD

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 NEW VIRGINIA RD
DOWNINGTOWN PA
19335-3686
US

IV. Provider business mailing address

1318 NEW VIRGINIA RD
DOWNINGTOWN PA
19335-3686
US

V. Phone/Fax

Practice location:
  • Phone: 484-354-7046
  • Fax:
Mailing address:
  • Phone: 484-354-7046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC7-0003280
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT186047
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD433258
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: