Provider Demographics
NPI:1144398850
Name:KATZ, CRAIG LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:LAWRENCE
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2727 PALISADE AVE
Mailing Address - Street 2:6D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1018
Mailing Address - Country:US
Mailing Address - Phone:347-427-4210
Mailing Address - Fax:212-860-3002
Practice Address - Street 1:1100 PARK AVE STE 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1202
Practice Address - Country:US
Practice Address - Phone:212-860-8665
Practice Address - Fax:212-860-3002
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2033802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G78421Medicare UPIN
NY60M972Medicare ID - Type Unspecified