Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kathryn O'Sullivan Stack, MD

Individual provider Pediatrics Physician · NPI 1174147540

Dr. Kathryn O'Sullivan Stack, MD is a Pediatrics Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2020.

Licensed in
PA
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-1220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence MT221148 (PA)

Record details

NPI number1174147540
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 2, 2020
Last updated in NPPESJune 2, 2020
Certification dateJune 2, 2020

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