Provider Demographics
NPI:1316557887
Name:SCOZZARI, KATHARINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:
Last Name:SCOZZARI
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 1:12 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1418
Mailing Address - Country:US
Mailing Address - Phone:914-450-9322
Mailing Address - Fax:
Practice Address - Street 1:1200 WATERS PL RM M108
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-0377
Practice Address - Country:US
Practice Address - Phone:914-450-9932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-08
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026175207VM0101X
NY026175-01363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine