Provider Demographics
NPI:1215572037
Name:DIANA NOMIKOS KATZ PA
Entity Type:Organization
Organization Name:DIANA NOMIKOS KATZ PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOMIKOS KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-449-5232
Mailing Address - Street 1:4832 NW 20TH PL
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7751
Mailing Address - Country:US
Mailing Address - Phone:954-224-0555
Mailing Address - Fax:954-840-8254
Practice Address - Street 1:2400 E COMMERCIAL BLVD
Practice Address - Street 2:723
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4131
Practice Address - Country:US
Practice Address - Phone:954-449-5232
Practice Address - Fax:954-840-8254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty