Provider Demographics
NPI:1235436114
Name:KATZ, SETH BENJAMIN (MS, ANP-BC)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:BENJAMIN
Last Name:KATZ
Suffix:
Gender:M
Credentials:MS, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 GIBSON ST
Mailing Address - Street 2:#306
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1258
Mailing Address - Country:US
Mailing Address - Phone:781-291-1097
Mailing Address - Fax:
Practice Address - Street 1:60 GIBSON ST
Practice Address - Street 2:#306
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-1258
Practice Address - Country:US
Practice Address - Phone:781-291-1097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN267687363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health