Provider Demographics
NPI:1861912230
Name:KATSNELSON, VIKTORIYA (MD)
Entity type:Individual
Prefix:DR
First Name:VIKTORIYA
Middle Name:
Last Name:KATSNELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29325 HEALTH CAMPUS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8201
Mailing Address - Country:US
Mailing Address - Phone:404-414-9400
Mailing Address - Fax:
Practice Address - Street 1:29325 HEALTH CAMPUS DR STE 3
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-8201
Practice Address - Country:US
Practice Address - Phone:440-414-9400
Practice Address - Fax:216-201-2551
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35139811207R00000X
OH57.029854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine