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General NPI Number Information
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NPI Number | 1326345562
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Entity Type | Individual
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Provider Name | KATHERINE E NUGENT DPT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 5548 CHESTNUT ST FIRST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3204
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Country | US
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Telephone | 215-471-3320
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 LOCUST ST APT. 1701
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6147
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Country | US
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Telephone | 609-703-0426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT020993
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License Number State | PA
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