Healthcare Provider Details

I. General information

NPI: 1982296810
Provider Name (Legal Business Name): KATRINA ANN SEIDEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 W WYOMISSING BLVD
READING PA
19609-2259
US

IV. Provider business mailing address

214 KEATS DR
READING PA
19608-1715
US

V. Phone/Fax

Practice location:
  • Phone: 610-775-3409
  • Fax:
Mailing address:
  • Phone: 610-223-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: