MEDICARE: JAY E. KATZEN 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	207W00000X	Ophthalmology Physician	0101027407	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689755357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY E. KATZEN M.D.

Provider Business Mailing Address
First Line	:	224 D CORNWALL STREET NW
Second Line	:	STE 403
City	:	LEESBURG
State	:	VA
Zip	:	20176-2704
Country	:	US
Telephone Number	:	703-737-6010
Fax Number	:	703-443-8643

Provider Business Practice Location Address
First Line	:	1901 N BEAUREGARD STREET, SUITE 100
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1721
Country	:	US
Telephone Number	:	703-931-9100
Fax Number	:	703-931-3415

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/19/2024

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