Provider Demographics
NPI:1235363615
Name:GILLIAN KATZ M.D., PLLC
Entity Type:Organization
Organization Name:GILLIAN KATZ M.D., PLLC
Other - Org Name:GILLIAN KATZ M.D., PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-421-6062
Mailing Address - Street 1:166 5TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5909
Mailing Address - Country:US
Mailing Address - Phone:646-421-6062
Mailing Address - Fax:646-895-7604
Practice Address - Street 1:166 5TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5909
Practice Address - Country:US
Practice Address - Phone:646-421-6062
Practice Address - Fax:646-895-7604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183999-1207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty