Provider Demographics
NPI:1639141914
Name:KATANY, ANASTASIA (DO)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:KATANY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-3116
Mailing Address - Country:US
Mailing Address - Phone:434-316-5000
Mailing Address - Fax:434-316-7071
Practice Address - Street 1:1600 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-3116
Practice Address - Country:US
Practice Address - Phone:434-316-5000
Practice Address - Fax:434-316-7071
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102049963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005622930Medicaid
VA080173124Medicare PIN
VA080007793Medicare PIN
VAG16633Medicare UPIN
VA017854C18Medicare PIN