Provider Demographics
NPI:1609002104
Name:KATZ, SUSAN B (MACCSLP)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:B
Last Name:KATZ
Suffix:
Gender:F
Credentials:MACCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2703
Mailing Address - Country:US
Mailing Address - Phone:212-585-4130
Mailing Address - Fax:
Practice Address - Street 1:240 E 82ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2703
Practice Address - Country:US
Practice Address - Phone:212-585-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009181-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist