Provider Demographics
NPI:1275099517
Name:KATSMAN, IRINA (PA-C)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:KATSMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30915 LORAIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4722
Mailing Address - Country:US
Mailing Address - Phone:440-617-6061
Mailing Address - Fax:
Practice Address - Street 1:30915 LORAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-4722
Practice Address - Country:US
Practice Address - Phone:440-617-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant