MEDICARE: MR. JOEL KATZ LCSW

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	1041C0700X	Clinical Social Worker	022898	NY

General Provider Information

NPI Number	:	1548259096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOEL KATZ LCSW

Provider Business Mailing Address
First Line	:	60 KNOLLS CRES
Second Line	:	9D
City	:	BRONX
State	:	NY
Zip	:	10463-6319
Country	:	US
Telephone Number	:	718-548-8927
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 CENTRAL PARK W
Second Line	:	SUITE 1F, ROOM 4
City	:	NEW YORK
State	:	NY
Zip	:	10024-3015
Country	:	US
Telephone Number	:	212-851-6077
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	06/22/2010

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