Healthcare Provider Details

I. General information

NPI: 1407192867
Provider Name (Legal Business Name): MICHAEL JAY KATZ PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 PRINCETON RD
ELIZABETH NJ
07208-1340
US

IV. Provider business mailing address

37 PRINCETON RD
ELIZABETH NJ
07208-1340
US

V. Phone/Fax

Practice location:
  • Phone: 908-907-8694
  • Fax: 732-363-8282
Mailing address:
  • Phone: 908-907-8694
  • Fax: 732-363-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: