Healthcare Provider Details

I. General information

NPI: 1477294593
Provider Name (Legal Business Name): DANIEL KATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE # LG065
FARMINGTON CT
06030-0001
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-4988
  • Fax: 860-679-3489
Mailing address:
  • Phone: 848-288-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number25MA12719600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: