Provider Demographics
NPI:1629144456
Name:KATZ, ROBERT JOEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOEL
Last Name:KATZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 SLEEPY HOLLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2526
Mailing Address - Country:US
Mailing Address - Phone:914-941-1814
Mailing Address - Fax:
Practice Address - Street 1:593 SLEEPY HOLLOW ROAD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-2526
Practice Address - Country:US
Practice Address - Phone:914-941-1814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00649954Medicaid
NY00649954Medicaid
NYV13332Medicare ID - Type Unspecified