Provider Demographics
NPI:1508815903
Name:KATZ, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 POOLE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2051
Mailing Address - Country:US
Mailing Address - Phone:732-888-0600
Mailing Address - Fax:732-264-8194
Practice Address - Street 1:812 POOLE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-2051
Practice Address - Country:US
Practice Address - Phone:732-888-0600
Practice Address - Fax:732-264-8194
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA032124207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2159406Medicaid
NJKA456625Medicare ID - Type UnspecifiedMEDICARE
NJ2159406Medicaid