Provider Demographics
NPI:1083630875
Name:OSTEN, KATHLEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:OSTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:100 HAZEL LN
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1249
Mailing Address - Country:US
Mailing Address - Phone:412-749-6806
Mailing Address - Fax:724-251-9875
Practice Address - Street 1:100 HAZEL LN
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1249
Practice Address - Country:US
Practice Address - Phone:412-749-6806
Practice Address - Fax:724-251-9875
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044675L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018940880002Medicaid
PA035952LCKMedicare PIN
G43753Medicare UPIN