Basic Information
| Provider Information | |||||||||
| NPI: | 1306028220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOKARSKY | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | ALISSA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 309 BOYER RD | ||||||||
| Address2: | |||||||||
| City: | CHELTENHAM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190121903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2678828897 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 34TH STREET AND CIVIC CENTER BOULEVARD | ||||||||
| Address2: | 1ST FLOOR WOOD BUILDING | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155903440 | ||||||||
| FaxNumber: | 2155903986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 12/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA052192 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.