Provider Demographics
NPI:1659833689
Name:LEBEDEV, KATYA (DO)
Entity Type:Individual
Prefix:
First Name:KATYA
Middle Name:
Last Name:LEBEDEV
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 1:458 HARSHBERGER RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3124
Mailing Address - Country:US
Mailing Address - Phone:678-333-5526
Mailing Address - Fax:
Practice Address - Street 1:4 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4721
Practice Address - Country:US
Practice Address - Phone:412-362-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program