Provider Demographics
NPI:1629328695
Name:KATZ, STEFANIE JOY (LAC)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:JOY
Last Name:KATZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 5TH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3401
Mailing Address - Country:US
Mailing Address - Phone:917-538-0606
Mailing Address - Fax:
Practice Address - Street 1:397 5TH ST
Practice Address - Street 2:APT 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3401
Practice Address - Country:US
Practice Address - Phone:917-538-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 004898171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist