Healthcare Provider Details

I. General information

NPI: 1508818212
Provider Name (Legal Business Name): VICTORIA KATZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1664 E 14TH ST SUITE 401
BROOKLYN NY
11229-1155
US

IV. Provider business mailing address

1725 E 12TH ST STE 101
BROOKLYN NY
11229-1068
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-2300
  • Fax: 718-513-6322
Mailing address:
  • Phone: 718-375-2300
  • Fax: 718-513-6322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number225323
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: