Healthcare Provider Details

I. General information

NPI: 1205275922
Provider Name (Legal Business Name): KATHERINE ELIZABETH UYHAZI M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2013
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 FILBERT ST STE 515
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

3801 FILBERT ST STE 515
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-8100
  • Fax: 215-243-3579
Mailing address:
  • Phone: 215-662-8100
  • Fax: 215-243-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD460187
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD460187
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: