Provider Demographics
NPI:1043235740
Name:KATZ, INGRID T (MD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:T
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PRINCE ST
Mailing Address - Street 2:APT.# 3
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4413
Mailing Address - Country:US
Mailing Address - Phone:617-732-6600
Mailing Address - Fax:
Practice Address - Street 1:BRIGHAM AND WOMAN'S HOSPITAL
Practice Address - Street 2:75 FRANCIS STREET
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine