Katharyn Bannar
Individual provider Active NPI Specialist · Whitehall, PA
NPI 1497323869 · NPPES record last updated Jun 14, 2021
Key facts
- NPI
- 1497323869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- SL015716 (PA)
- Practice address
- 4150 Redbud Dr W
Whitehall, PA 18052-1952 - Phone
- (610) 739-8654
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL015716 | PA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapyties | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | SL015716 | PA | Yes |
Addresses
Primary practice location
4150 Redbud Dr W
Whitehall, PA 18052-1952
Mailing address
4150 Redbud Dr W
Whitehall, PA 18052-1952
Phone (610) 739-8654
Other providers in Whitehall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.