MEDICARE: MR. GERALD B KATZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	34409	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	20534	OTHER	MA	HPHC
3	KAB33362	OTHER	MA	BCBS
4	355285	OTHER		CIGNA
5	034409	OTHER		TUFTS
6	419427	OTHER		TUFTS USFHP

General Provider Information

NPI Number	:	1730170101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GERALD B KATZ MD

Provider Business Mailing Address
First Line	:	549 COLUMBIAN ST
Second Line	:	SUITE 100
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1138
Country	:	US
Telephone Number	:	781-337-5680
Fax Number	:	781-337-3275

Provider Business Practice Location Address
First Line	:	549 COLUMBIAN ST
Second Line	:	SUITE 100
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1138
Country	:	US
Telephone Number	:	781-337-5680
Fax Number	:	781-337-3275

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	05/18/2012

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