MEDICARE: DR. EDWARD KATIME 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	174400000X	Specialist	143976	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04001367	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	131154	OTHER	NY	GREAT WEST ONE HEALTH PLA
3	65A311	OTHER	NY	BLUE CROSS BLUE SHIELD
4	OC6302	OTHER	NY	HEALTH NET INSURANCE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	10-00001	OTHER	NY	UNITED HEALTHCARE
7	AL46518	OTHER	NY	MDNY
8	AS1107	OTHER	NY	OXFORD
9	449	OTHER	NY	VYTRA HEALTH PLANS
10	53593	OTHER	NY	GHI HMO
11	0061915	OTHER	NY	GHI INSURANCE

General Provider Information

NPI Number	:	1891776084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD KATIME M.D.

Provider Business Mailing Address
First Line	:	877 STEWART AVE
Second Line	:	SUITE 8
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4803
Country	:	US
Telephone Number	:	516-222-1616
Fax Number	:	516-222-0437

Provider Business Practice Location Address
First Line	:	877 STEWART AVE
Second Line	:	SUITE 8
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4803
Country	:	US
Telephone Number	:	516-222-1616
Fax Number	:	516-222-0437

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	02/11/2009

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