Provider Demographics
NPI:1396034815
Name:KATLOWITZ, SHARI JILL (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:JILL
Last Name:KATLOWITZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 NEW MCNEIL AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1726
Mailing Address - Country:US
Mailing Address - Phone:917-923-1776
Mailing Address - Fax:718-868-2299
Practice Address - Street 1:1058 NEW MCNEIL AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1726
Practice Address - Country:US
Practice Address - Phone:917-923-1776
Practice Address - Fax:718-868-2299
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY359168911174400000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist