Provider Demographics
NPI:1588683312
Name:KATZ, ERIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3180 MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4237
Mailing Address - Country:US
Mailing Address - Phone:203-371-4424
Mailing Address - Fax:203-371-4828
Practice Address - Street 1:3180 MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4237
Practice Address - Country:US
Practice Address - Phone:203-371-4424
Practice Address - Fax:203-371-4828
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT022585207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD32594Medicare UPIN
CT0445660001Medicare NSC