Provider Demographics
NPI:1588661896
Name:FORTE-KATZ, CLORINDA (DC)
Entity Type:Individual
Prefix:DR
First Name:CLORINDA
Middle Name:
Last Name:FORTE-KATZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W PENN AVE
Mailing Address - Street 2:
Mailing Address - City:ROBESONIA
Mailing Address - State:PA
Mailing Address - Zip Code:19551-1503
Mailing Address - Country:US
Mailing Address - Phone:610-693-9556
Mailing Address - Fax:610-693-9565
Practice Address - Street 1:141 W PENN AVE
Practice Address - Street 2:
Practice Address - City:ROBESONIA
Practice Address - State:PA
Practice Address - Zip Code:19551-1503
Practice Address - Country:US
Practice Address - Phone:610-693-9556
Practice Address - Fax:610-693-9565
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003948L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA658474Medicare ID - Type Unspecified