Provider Demographics
NPI:1700192176
Name:KAMINSKI, KATHERINE VICTORIA (PA)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:VICTORIA
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1815 W 13TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4054
Mailing Address - Country:US
Mailing Address - Phone:302-652-4705
Mailing Address - Fax:302-652-2917
Practice Address - Street 1:1815 W 13TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4054
Practice Address - Country:US
Practice Address - Phone:302-652-4705
Practice Address - Fax:302-652-2917
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000707363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical