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General NPI Number Information
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NPI Number | 1144222654
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Entity Type | Individual
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Provider Name | ALEXANDRA L CHAN KATZ DDS, MPH
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 58 RUTLEDGE ST ODA PRIMARY HEALTH CARE NETWORK- DIRECTOR DENTAL
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City | BROOKLYN
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State | NY
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Zip | 11249-7814
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Country | US
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Telephone | 718-260-4620
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Fax |
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Provider Business Mailing Address
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Address Line | 14 HEYWARD ST
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City | BROOKLYN
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State | NY
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Zip | 11249-7823
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Country | US
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Telephone | 718-260-4600
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Fax | 914-764-5605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0478090
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 008620
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 047809
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License Number State | NY
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