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1093221392 NPI number — KATZEN MEDICAL ASSOCIATES, PC

NPI Number: 1093221392
Health Care Provider/Practitioner: KATZEN MEDICAL ASSOCIATES, PC

Information about “1093221392” NPI (KATZEN MEDICAL ASSOCIATES, PC) exists in 1093221392 in HTML format HTML  |  1093221392 in plain Text format TXT  |  1093221392 in PDF (Portable Document Format) PDF  |  1093221392 in an XML format XML  formats.

NPI Number : 1093221392 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093221392",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KATZEN MEDICAL ASSOCIATES, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1209 YORK RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LUTHERVILLE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21093-6220",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "410-821-9490",
    "MailingAddressFaxNumber": "410-821-9495",
    "FirstLinePracticeLocationAddress": "111 MOUNT CARMEL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PARKTON",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21120-9706",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "410-329-6700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/21/2017",
    "LastUpdateDate": "02/05/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "NEAL",
    "AuthorizedOfficialFirstName": "GEORGE",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "469-214-0144",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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