Provider Demographics
NPI:1639571862
Name:FATIGANTE, KATHRYN E (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:FATIGANTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:FERCHAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-9159
Mailing Address - Fax:412-647-9160
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:SUITE 5B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-9159
Practice Address - Fax:412-647-9160
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057193363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical