Provider Demographics
NPI:1346232113
Name:SCHAFER, KATRINA M (PA)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:M
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:M
Other - Last Name:FOLLWEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-2200
Mailing Address - Fax:866-829-9836
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-2200
Practice Address - Fax:866-829-9836
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052003363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ46126Medicare UPIN