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General NPI Number Information
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NPI Number | 1609032788
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Entity Type | Organization
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Legal Business Name | RONALD I. KAITZ, M.D. PC
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 297 KNOLLWOOD RD SUITE 207
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1833
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Country | US
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Telephone | 914-524-8913
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Fax |
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Provider Business Mailing Address
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Address Line | 297 KNOLLWOOD RD SUITE 207
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD I KAITZ
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Credential | M.D.
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Telephone | 914-524-8913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 139213
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License Number State | NY
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