Healthcare Provider Details

I. General information

NPI: 1548502909
Provider Name (Legal Business Name): ACCESS MEDICAL CONSULTANTS PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 N DEAN ST STE 203
ENGLEWOOD NJ
07631-2523
US

IV. Provider business mailing address

177 N DEAN ST STE 203
ENGLEWOOD NJ
07631-2523
US

V. Phone/Fax

Practice location:
  • Phone: 917-903-4886
  • Fax:
Mailing address:
  • Phone: 917-903-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number25MAO7781500
License Number StateNJ

VIII. Authorized Official

Name: DR. DORON ZVI KATZ
Title or Position: PRESIDENT
Credential: MD
Phone: 917-903-4886