Provider Demographics
NPI:1639126584
Name:OLTYAN, KARIN SUE (MD)
Entity Type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:SUE
Last Name:OLTYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:
Other - Last Name:KRAKOVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:2000 OXFORD DR STE 302
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1841
Practice Address - Country:US
Practice Address - Phone:412-942-8570
Practice Address - Fax:412-942-8589
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD460327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103470827-0002Medicaid