Provider Demographics
NPI:1245214626
Name:KATZ, ALAN JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JEFFREY
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 STATE RD
Mailing Address - Street 2:WATUPPA BLDG STE 203
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3322
Mailing Address - Country:US
Mailing Address - Phone:508-994-0120
Mailing Address - Fax:508-996-9636
Practice Address - Street 1:49 STATE RD
Practice Address - Street 2:WATUPPA BLDG STE 203
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3322
Practice Address - Country:US
Practice Address - Phone:508-994-0120
Practice Address - Fax:508-996-9636
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80984207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3147363Medicaid
KAA20863Medicare ID - Type Unspecified
MA3147363Medicaid