Healthcare Provider Details
I. General information
NPI: 1326052614
Provider Name (Legal Business Name): KATZEN MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1209 YORK RD SUITE 200
LUTHERVILLE MD
21093-6207
US
IV. Provider business mailing address
1209 YORK RD
LUTHERVILLE MD
21093-6220
US
V. Phone/Fax
- Phone: 410-821-9490
- Fax: 410-821-9495
- Phone: 410-821-9490
- Fax: 410-821-9495
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GEORGE
NEAL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 844-377-6468