Healthcare Provider Details
I. General information
NPI: 1346553799
Provider Name (Legal Business Name): ALVIN KATZ MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2010
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 E 72ND ST 1A
NEW YORK NY
10021-4148
US
IV. Provider business mailing address
45 E 72ND ST 1A
NEW YORK NY
10021-4148
US
V. Phone/Fax
- Phone: 212-879-3292
- Fax: 212-988-2507
- Phone: 212-879-3292
- Fax: 212-988-2507
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | 092277 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | MA21932 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
ALVIN
KATZ
Title or Position: OWNER
Credential: MD
Phone: 212-879-3292