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General NPI Number Information
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NPI Number | 1992232441
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Entity Type | Organization
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Legal Business Name | NICHOLAS S KATCHEN DDS PC
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 155 E MAIN ST
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City | PORT JERVIS
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State | NY
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Zip | 12771-2113
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Country | US
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Telephone | 845-856-5049
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Fax |
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Provider Business Mailing Address
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Address Line | 228 E ROUTE 59 STE 414
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City | NANUET
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State | NY
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Zip | 10954-2905
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Country | US
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Telephone | 917-282-2934
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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. NICHOLAS SEAN KATCHEN
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Credential | DDS
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Telephone | 917-282-2934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 057362
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License Number State | NY
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