Provider Demographics
NPI:1417459249
Name:KATZ, ERIC BRIAN (CPO, LPO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:BRIAN
Last Name:KATZ
Suffix:
Gender:M
Credentials:CPO, LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PILOT RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2034
Mailing Address - Country:US
Mailing Address - Phone:732-890-8234
Mailing Address - Fax:
Practice Address - Street 1:210 NEW RD STE 7
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1371
Practice Address - Country:US
Practice Address - Phone:609-653-8323
Practice Address - Fax:609-653-4295
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45PO00017200222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist