Provider Demographics
NPI:1518777606
Name:KRATOFILOW, NANCY MATILDE
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MATILDE
Last Name:KRATOFILOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4319
Mailing Address - Country:US
Mailing Address - Phone:267-207-9646
Mailing Address - Fax:
Practice Address - Street 1:3006 CEDAR ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4319
Practice Address - Country:US
Practice Address - Phone:267-207-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician