Healthcare Provider Details

I. General information

NPI: 1306947114
Provider Name (Legal Business Name): BRIAN J KATZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 ATLANTIC AVE
EAST ROCKAWAY NY
11518-1530
US

IV. Provider business mailing address

559 ATLANTIC AVE
EAST ROCKAWAY NY
11518-1530
US

V. Phone/Fax

Practice location:
  • Phone: 516-593-8333
  • Fax: 516-593-8344
Mailing address:
  • Phone: 516-593-8333
  • Fax: 516-593-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX3346
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: