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NPI Code Detail

MEDICARE: DR. ELISHEVA RENA KATZ PSY.D.

MEDICARE: DR. ELISHEVA RENA KATZ PSY.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
1103TS0200XSchool Psychologist
2103T00000XPsychologist022597NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1022597OTHERNYLICENSURE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31407211OTHERNYUNIVERSITY OF THE STATE OF NEW YORK: EDUCATION DEPARTMENT

General Provider Information

NPI Number : 1568837409
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELISHEVA RENA KATZ PSY.D.
Provider Business Mailing Address
First Line : 142 VAN HOUTEN AVE APT 1
Second Line :
City : PASSAIC
State : NJ
Zip : 07055-4602
Country : US
Telephone Number : 201-316-6592
Fax Number :
Provider Business Practice Location Address
First Line : 1 HAMASPIK WAY
Second Line :
City : MONROE
State : NY
Zip : 10950-8451
Country : US
Telephone Number : 845-655-0600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2015
Last Update Date : 06/15/2020

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