Healthcare Provider Details

I. General information

NPI: 1275556557
Provider Name (Legal Business Name): PHILIP JAY KATZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF ROCHESTER MEDICAL CTR 601 ELMWOOD AVE, BOX 626
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

103 TARRYTOWN RD
ROCHESTER NY
14618-1429
US

V. Phone/Fax

Practice location:
  • Phone: 585-273-4091
  • Fax: 585-273-3637
Mailing address:
  • Phone: 585-273-4091
  • Fax: 585-273-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number219004
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number219004-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number219004-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: