Provider Demographics
NPI:1790001485
Name:LACKRITZ, KATHERINE DEOREO (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:DEOREO
Last Name:LACKRITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:834 CHESTNUT STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5127
Mailing Address - Country:US
Mailing Address - Phone:215-955-5000
Mailing Address - Fax:215-923-1089
Practice Address - Street 1:834 CHESTNUT STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5127
Practice Address - Country:US
Practice Address - Phone:215-955-5000
Practice Address - Fax:215-923-1089
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255785207V00000X
PAMD443245207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology