Individual
KATHLEEN A. HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C10009425
DE
207L00000X
Anesthesiology Physician
MD436485
PA
207L00000X
Anesthesiology Physician
MT186753
PA
207LP3000X
Pediatric Anesthesiology Physician
C10009425
DE
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD436485
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025126370002
—
PA
01
—
246423EJL
MEDICARE PTAN
PA
Enumeration date
12/21/2006
Last updated
06/01/2023
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