Provider Demographics
NPI:1457511719
Name:WOOZLEY, KATHARINE THERESA (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:THERESA
Last Name:WOOZLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:THERESA
Other - Last Name:CRINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:WILLOWCREST 4TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:215-456-7900
Mailing Address - Fax:215-456-5948
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:WILLOWCREST 4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-7900
Practice Address - Fax:215-456-5948
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193683207X00000X
NY268853207XS0106X, 390200000X
PAMD444269207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program