=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326052614
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATZEN MEDICAL ASSOCIATES, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2006
-----------------------------------------------------
Last Update Date | 01/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1209 YORK RD SUITE 200
-----------------------------------------------------
City | LUTHERVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21093-6207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-821-9490
-----------------------------------------------------
Fax | 410-821-9495
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1209 YORK RD
-----------------------------------------------------
City | LUTHERVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21093-6220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-821-9490
-----------------------------------------------------
Fax | 410-821-9495
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. GEORGE NEAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 844-377-6468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------