Healthcare Provider Details

I. General information

NPI: 1376532457
Provider Name (Legal Business Name): DEBRA CARI KATZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MAIN ST
PATERSON NJ
07503-2621
US

IV. Provider business mailing address

703 MAIN ST
PATERSON NJ
07503-2621
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-2720
  • Fax: 973-754-4999
Mailing address:
  • Phone: 973-754-2720
  • Fax: 973-754-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF0006211
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00027101
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: