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NPI Code Detail

MEDICARE: RAISA KATZ D.O

MEDICARE: RAISA KATZ D.O
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
1207Q00000XFamily Medicine Physician255754NY

General Provider Information

NPI Number : 1740511633
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAISA KATZ D.O
Provider Business Mailing Address
First Line : 1800 AVENUE L
Second Line : APT B -7
City : BROOKLYN
State : NY
Zip : 11230-4463
Country : US
Telephone Number : 718-570-7665
Fax Number :
Provider Business Practice Location Address
First Line : 1800 AVENUE L
Second Line : APT B -7
City : BROOKLYN
State : NY
Zip : 11230-4463
Country : US
Telephone Number : 718-570-7665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2010
Last Update Date : 01/18/2010

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