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General NPI Number Information
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NPI Number | 1538387964
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Entity Type | Individual
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Provider Name | JACOB KATZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 74 US HIGHWAY 9 STE 1
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726-9209
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Country | US
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Telephone | 732-762-5005
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Fax | 732-410-4676
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Provider Business Mailing Address
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Address Line | 74 US HIGHWAY 9 STE 1
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726-9209
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Country | US
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Telephone | 732-762-5005
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Fax | 732-410-4676
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 25MA10151200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME 126965
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 286279
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License Number State | NY
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