Provider Demographics
NPI:1326202391
Name:PERSCKY, KATHERINE MARY (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARY
Last Name:PERSCKY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:MARY
Other - Last Name:PASKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1941 LIMESTONE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5413
Mailing Address - Country:US
Mailing Address - Phone:302-633-3555
Mailing Address - Fax:302-999-8645
Practice Address - Street 1:114 SANDHILL DR
Practice Address - Street 2:STE 103
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5805
Practice Address - Country:US
Practice Address - Phone:302-655-9494
Practice Address - Fax:302-351-4898
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005997213ES0103X
DEE1-0000206213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
225268ZC2LMedicare UPIN