MEDICARE: NICHOLAS KATZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	35.135876	OH

General Provider Information

NPI Number	:	1548246978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS KATZ M.D.

Provider Business Mailing Address
First Line	:	1932 NILES CORTLAND RD NE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1055
Country	:	US
Telephone Number	:	330-306-5258
Fax Number	:	330-306-5259

Provider Business Practice Location Address
First Line	:	1932 NILES CORTLAND RD NE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1055
Country	:	US
Telephone Number	:	330-306-5258
Fax Number	:	330-306-5259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2005
Last Update Date	:	03/07/2023

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