Provider Demographics
NPI:1043289887
Name:KATZMAN, BARRY ALLEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALLEN
Last Name:KATZMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24825 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1836
Mailing Address - Country:US
Mailing Address - Phone:718-470-0668
Mailing Address - Fax:718-470-0669
Practice Address - Street 1:24825 UNION TPKE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1836
Practice Address - Country:US
Practice Address - Phone:718-470-0669
Practice Address - Fax:718-470-0669
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003570213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00830502Medicaid
T32183Medicare UPIN
NY94637Medicare ID - Type Unspecified