MEDICARE: DR. KATHLEEN C DILLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MD439734	PA
2	2084P0800X	Psychiatry Physician	MD439734	PA
3	2084P0800X	Psychiatry Physician	186531	PA

General Provider Information

NPI Number	:	1679729545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN C DILLER MD

Provider Business Mailing Address
First Line	:	3535 MARKET ST.
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-746-6700
Fax Number	:	215-746-5155

Provider Business Practice Location Address
First Line	:	3535 MARKET ST.
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-746-6700
Fax Number	:	215-746-5155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	03/10/2026

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