Provider Demographics
NPI:1578119665
Name:NAROUZ, KATARINA
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:NAROUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E GATE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2105
Mailing Address - Country:US
Mailing Address - Phone:516-745-8050
Mailing Address - Fax:
Practice Address - Street 1:1500 ROUTE 112 BLDG 9
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3184
Practice Address - Country:US
Practice Address - Phone:631-849-6688
Practice Address - Fax:631-849-6689
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist