Healthcare Provider Details

I. General information

NPI: 1134160146
Provider Name (Legal Business Name): MARTIN E. KATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 WHITNEY AVENUE, SUITE 240 MEDICAL ONCOLOGY & HEMATOLOGY, PC
HAMDEN CT
06518
US

IV. Provider business mailing address

19 LUNAR DRIVE MEDICAL ONCOLOGY & HEMATOLOGY, PC
WOODBRIDGE CT
06525
US

V. Phone/Fax

Practice location:
  • Phone: 203-407-8002
  • Fax: 203-407-8038
Mailing address:
  • Phone: 203-389-7504
  • Fax: 203-389-1666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number018670
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number018670
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: