Provider Demographics
NPI:1346010675
Name:KATZ, BRACHA (PSYD)
Entity Type:Individual
Prefix:
First Name:BRACHA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 HOLLYWOOD BLVD STE 5469
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4821
Mailing Address - Country:US
Mailing Address - Phone:973-264-0023
Mailing Address - Fax:973-264-0022
Practice Address - Street 1:85 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2437
Practice Address - Country:US
Practice Address - Phone:973-264-0023
Practice Address - Fax:973-264-0022
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00734600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical