Provider Demographics
NPI:1629836168
Name:BARTELT, KATALINA MICHELLE
Entity Type:Individual
Prefix:
First Name:KATALINA
Middle Name:MICHELLE
Last Name:BARTELT
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 1:708 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:TULLY
Mailing Address - State:NY
Mailing Address - Zip Code:13159-3319
Mailing Address - Country:US
Mailing Address - Phone:786-519-8218
Mailing Address - Fax:
Practice Address - Street 1:708 NORTH RD
Practice Address - Street 2:
Practice Address - City:TULLY
Practice Address - State:NY
Practice Address - Zip Code:13159-3319
Practice Address - Country:US
Practice Address - Phone:786-519-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program