Healthcare Provider Details

I. General information

NPI: 1982518676
Provider Name (Legal Business Name): GRACE KATA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 MOSSIDE BLVD
MONROEVILLE PA
15146-2760
US

IV. Provider business mailing address

1679 WATERFRONT PL APT 141B
PITTSBURGH PA
15222-5003
US

V. Phone/Fax

Practice location:
  • Phone: 412-357-3061
  • Fax:
Mailing address:
  • Phone: 516-314-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: