Provider Demographics
NPI:1770014169
Name:PIVARNIK, KATIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:PIVARNIK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 CONGRESS ST
Mailing Address - Street 2:STE 102
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0907
Mailing Address - Country:US
Mailing Address - Phone:617-471-1161
Mailing Address - Fax:617-376-0435
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:DEPT. OF OB/GYN
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-264-5026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2021-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAT288592207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology