Provider Demographics
NPI:1598892812
Name:KATZ, THEODORE T (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:T
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 1:1127 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976
Mailing Address - Country:US
Mailing Address - Phone:215-491-2000
Mailing Address - Fax:215-491-7000
Practice Address - Street 1:1127 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976
Practice Address - Country:US
Practice Address - Phone:215-491-2000
Practice Address - Fax:215-491-7000
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023650E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery