Provider Demographics
NPI:1477555993
Name:KATZ, STEVEN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GRAND AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4398
Mailing Address - Country:US
Mailing Address - Phone:201-816-1900
Mailing Address - Fax:201-816-1777
Practice Address - Street 1:300 GRAND AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4398
Practice Address - Country:US
Practice Address - Phone:201-816-1900
Practice Address - Fax:201-816-1777
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03291800208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2356655OtherAETNA HMO #
NY00318396Medicaid
NJ1099845OtherGHI PPO #
NJ324531OtherEMPIRE BC/BS #
NJ4226901OtherAETNA PPO #
NJ4716507Medicaid
NJ340015152OtherRAILROAD MDCR #
NJ324531OtherEMPIRE BC/BS #
NJ006501L08Medicare PIN