Provider Demographics
NPI:1306186739
Name:PANZA, KATE IRELAND
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:IRELAND
Last Name:PANZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 KRUG CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-1914
Mailing Address - Country:US
Mailing Address - Phone:518-860-8716
Mailing Address - Fax:
Practice Address - Street 1:29 KRUG CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-1914
Practice Address - Country:US
Practice Address - Phone:518-860-8716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist