Provider Demographics
NPI:1508857814
Name:KATZ, HARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
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 1:44 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1969
Mailing Address - Country:US
Mailing Address - Phone:201-445-2900
Mailing Address - Fax:201-445-8679
Practice Address - Street 1:44 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1969
Practice Address - Country:US
Practice Address - Phone:201-445-2900
Practice Address - Fax:201-445-8679
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41970174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC60955Medicare UPIN
469083BMKMedicare PIN