Healthcare Provider Details

I. General information

NPI: 1962918268
Provider Name (Legal Business Name): KATZEN MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL ST STE 902
BALTIMORE MD
21202-2102
US

IV. Provider business mailing address

1209 YORK RD
LUTHERVILLE MD
21093-6220
US

V. Phone/Fax

Practice location:
  • Phone: 410-727-8380
  • Fax:
Mailing address:
  • Phone: 410-821-9490
  • Fax: 410-821-9495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE L NEAL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 469-214-0144