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General NPI Number Information
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NPI Number | 1790766541
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Entity Type | Organization
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Legal Business Name | EDWARD KATIME, M.D.,P.C.
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 877 STEWART AVE SUITE 8
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City | GARDEN CITY
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State | NY
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Zip | 11530-4803
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Country | US
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Telephone | 516-222-1616
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Fax | 516-222-0437
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Provider Business Mailing Address
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Address Line | 877 STEWART AVE SUITE 8
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City | GARDEN CITY
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State | NY
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Zip | 11530-4803
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Country | US
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Telephone | 516-222-1616
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Fax | 516-222-0437
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD KATIME
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Credential | M.D.
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Telephone | 516-222-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 143976
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License Number State | NY
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