Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101245189 | VA |
NPI | 1013125772 |
---|---|
Provider Name | Katherine M Czyszczon |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 24/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013125772 | (05) | VA |