Provider Demographics
NPI:1881040160
Name:KATERYNA DUKENSKI, LLC
Entity Type:Organization
Organization Name:KATERYNA DUKENSKI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATERYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKENSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:484-441-3322
Mailing Address - Street 1:100 W SIXTH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2428
Mailing Address - Country:US
Mailing Address - Phone:484-441-3322
Mailing Address - Fax:
Practice Address - Street 1:100 W SIXTH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2428
Practice Address - Country:US
Practice Address - Phone:484-441-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017783251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare