Healthcare Provider Details

I. General information

NPI: 1538039656
Provider Name (Legal Business Name): KATERINA ZAGOROVSKAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 BORBECK AVE
PHILADELPHIA PA
19152-3802
US

IV. Provider business mailing address

2326 BORBECK AVE
PHILADELPHIA PA
19152-3802
US

V. Phone/Fax

Practice location:
  • Phone: 917-981-8753
  • Fax:
Mailing address:
  • Phone: 917-981-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK001507
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: