MEDICARE: DOUGLAS KATZ

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	174400000X	Specialist
2	103T00000X	Psychologist	8700	MA

General Provider Information

NPI Number	:	1588729883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS KATZ

Provider Business Mailing Address
First Line	:	124 WOODBINE CIR
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494-2152
Country	:	US
Telephone Number	:	617-272-0892
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 WOODBINE CIR
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494-2152
Country	:	US
Telephone Number	:	617-272-0892
Fax Number	:

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	03/15/2016

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Directions to “ DOUGLAS KATZ ” Practice Location

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