MEDICARE: KATE BARTOLOTTA

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	103T00000X	Psychologist	PS020693	PA

General Provider Information

NPI Number	:	1720723042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE BARTOLOTTA

Provider Business Mailing Address
First Line	:	7904 GERMANTOWN AVE APT 1R
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-3545
Country	:	US
Telephone Number	:	631-278-3812
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-4636
Country	:	US
Telephone Number	:	800-879-2467
Fax Number	:

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

Provider Enumeration Date	:	05/02/2022
Last Update Date	:	03/11/2026

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Directions to “ KATE BARTOLOTTA ” Practice Location

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