Provider Demographics
NPI:1275621054
Name:KATZMAN, STUART R (PT)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:R
Last Name:KATZMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 E. CAPITOL EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121
Mailing Address - Country:US
Mailing Address - Phone:408-270-2280
Mailing Address - Fax:408-270-1902
Practice Address - Street 1:1624 E. CAPITOL EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121
Practice Address - Country:US
Practice Address - Phone:408-270-2280
Practice Address - Fax:408-270-1902
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT147290Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER