Basic Information
| Provider Information | |||||||||
| NPI: | 1942320122 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALATNA | ||||||||
| FirstName: | OKSANA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 447 | ||||||||
| Address2: | |||||||||
| City: | DU BOIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158010447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143752070 | ||||||||
| FaxNumber: | 8143752076 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 HOSPITAL AVE | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | DU BOIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158011462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143752070 | ||||||||
| FaxNumber: | 8143752076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 06/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | OS013532 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 1021918620001 | 05 | PA | MEDICAID |