Provider Demographics
NPI:1376532457
Name:KATZ, DEBRA CARI (CNM)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:CARI
Last Name:KATZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2720
Mailing Address - Fax:973-754-4999
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2720
Practice Address - Fax:973-754-4999
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF0006211176B00000X
NJ25ME00027101176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1000027005OtherAFFINITY #
NY208573OtherWELLCARE #
NY400221OtherMVP #
NYP2590519OtherOXFORD #
NY060621OtherCONNECTICARE #
NY2800215OtherAETNA HMO #
NY0D3067OtherHEALTHNET #
NY1899751OtherGHI PPO #
NY02158501Medicaid
NYF000621OtherHIP #
NY000000074459OtherGHI HMO #
NY5942467OtherAETNA PPO #
NJMGM821OtherEMPIRE BCBS #
NYKD0621OtherATLANTIS HEALTH PLAN #
NY060621OtherCONNECTICARE #
NYP33651Medicare UPIN