Individual
KATHERINE L NATHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, 1ST FLOOR, SUITE 300 S, PHILADELPHIA, PA 19104-4306
(215) 662-4740
(215) 614-0298
Mailing address
3400 CIVIC CENTER BLVD, 1ST FLOOR, SUITE 300 S, PHILADELPHIA, PA 19104-4306
(215) 662-4740
(215) 614-0298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD059456L
PA
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD059456L
PA
208000000X
Pediatrics Physician
MD059456L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017645000001
—
PA
05
—
0092941
—
NJ
Enumeration date
06/23/2006
Last updated
10/29/2018
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