Provider Demographics
NPI:1003009598
Name:KATZ, ANITA WEINREB (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:WEINREB
Last Name:KATZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANITA
Other - Middle Name:CYRELE
Other - Last Name:WEINREB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:108 E 91ST ST APT 6A
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1656
Mailing Address - Country:US
Mailing Address - Phone:212-722-8621
Mailing Address - Fax:212-987-4194
Practice Address - Street 1:108 E 91ST ST APT 6A
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1656
Practice Address - Country:US
Practice Address - Phone:212-722-8621
Practice Address - Fax:212-987-4194
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X, 103T00000X, 103TA0700X, 103TC2200X, 106H00000X
NY003195103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV40361Medicare PIN