Basic Information
Provider Information
NPI: 1477916245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TEMPERATO
FirstName: YEKATERINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 843966
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641843966
CountryCode: US
TelephoneNumber: 5738843300
FaxNumber: 5738840943
Practice Location
Address1: 1100 VIRGINIA AVE
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652120001
CountryCode: US
TelephoneNumber: 5738822663
FaxNumber: 5738841284
Other Information
ProviderEnumerationDate: 03/30/2016
LastUpdateDate: 10/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XOS020601PAN Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
208100000X2021015390MON Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2081S0010X2021015390MOY Allopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine

No ID Information.


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