Provider Demographics
NPI:1669609343
Name:PELCZAR-WISSNER, CATHERINE JOSEPHINE (M D)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOSEPHINE
Last Name:PELCZAR-WISSNER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BRENNAN DR
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2002
Mailing Address - Country:US
Mailing Address - Phone:914-450-6755
Mailing Address - Fax:
Practice Address - Street 1:48 BRENNAN DR
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2002
Practice Address - Country:US
Practice Address - Phone:914-450-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD474176207RH0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology