Basic Information
| Provider Information | |||||||||
| NPI: | 1104828581 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZUCKERMAN | ||||||||
| FirstName: | KATALIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 BALDWICK RD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152054140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129226262 | ||||||||
| FaxNumber: | 4129225026 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 OXFORD DR STE 420 | ||||||||
| Address2: | |||||||||
| City: | BETHEL PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151021841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129428500 | ||||||||
| FaxNumber: | 4129428519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 01/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD033415-E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1104313 | 05 | PA | MEDICAID |