Provider Demographics
NPI:1730296906
Name:BARZILAI, KATHRYN YUKO (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:YUKO
Last Name:BARZILAI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:YUKO
Other - Last Name:BARZILAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASTELLANO
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5000
Mailing Address - Fax:
Practice Address - Street 1:30 CAPITAL DR
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1350
Practice Address - Country:US
Practice Address - Phone:413-794-6411
Practice Address - Fax:413-794-6685
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258167363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q60585Medicare UPIN
NP19971Medicare ID - Type Unspecified