Provider Demographics
NPI:1598158933
Name:BURTON J KATZEN DPM, LLC
Entity Type:Organization
Organization Name:BURTON J KATZEN DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BURTON
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-760-2232
Mailing Address - Street 1:4302 SAINT BARNABAS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1842
Mailing Address - Country:US
Mailing Address - Phone:301-760-2232
Mailing Address - Fax:
Practice Address - Street 1:4302 SAINT BARNABAS RD
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1842
Practice Address - Country:US
Practice Address - Phone:301-760-2232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00317332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site