Individual
MS. KATHLEEN BOCZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1900 N 9TH ST, SUITE 104, PHILADELPHIA, PA 19122-1909
(215) 765-6690
(215) 765-6694
Mailing address
1500 MARKET STREET, LM 500 WEST TOWER, PHILADELPHIA, PA 19120-2100
(215) 985-2595
(215) 765-6694
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP000980B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018132210001
—
PA
01
—
1487818
AETNA
PA
01
—
1590263
BLUE CROSS
PA
01
—
16605
BRAVO
PA
01
—
2268271000
KEYSTONE HEALTH PLAN EAST
PA
01
—
30027018
KEYSTONE MERCY HEALTH PLAN
PA
Enumeration date
06/11/2006
Last updated
07/14/2016
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