Provider Demographics
NPI:1881278414
Name:RASCOVSKY, KATYA (PHD)
Entity type:Individual
Prefix:DR
First Name:KATYA
Middle Name:
Last Name:RASCOVSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATYA
Other - Middle Name:
Other - Last Name:RASCOVSKY RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3400 CIVIC CENTER BOULEVARD, SOUTH PAVILION
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-615-2489
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BOULEVARD, SOUTH PAVILION
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-615-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018938103G00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist