Healthcare Provider Details

I. General information

NPI: 1336168822
Provider Name (Legal Business Name): MATTHEW STRAUSS KATZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 603-230-6100
  • Fax: 603-230-6105
Mailing address:
  • Phone: 800-866-6663
  • Fax: 888-413-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number12304
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number216655
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: