Healthcare Provider Details

I. General information

NPI: 1568663672
Provider Name (Legal Business Name): DAVID KATZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE 1ST FL STE 1511
ATLANTIC CITY NJ
08401
US

IV. Provider business mailing address

1925 PACIFIC AVE 1ST FL STE 1511
ATLANTIC CITY NJ
08401
US

V. Phone/Fax

Practice location:
  • Phone: 609-441-8165
  • Fax: 609-593-9850
Mailing address:
  • Phone: 609-441-8165
  • Fax: 609-593-9850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00181300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: