Provider Demographics
NPI:1356509996
Name:KOHARI, KATHERINE SHISTER (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SHISTER
Last Name:KOHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:WALLACE
Other - Last Name:SHISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:YALE SCHOOL OF MEDICINE 333 CEDAR ST. P.O. BOX 208063
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8063
Mailing Address - Country:US
Mailing Address - Phone:203-785-5855
Mailing Address - Fax:203-785-6885
Practice Address - Street 1:1 LONG WHARF DR FL 2
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-688-2800
Practice Address - Fax:203-688-2806
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250868207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine