Provider Demographics
NPI:1659096956
Name:KATZ, ELLIOTT (RPH)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4009
Mailing Address - Country:US
Mailing Address - Phone:732-970-0016
Mailing Address - Fax:
Practice Address - Street 1:483 HWY 79
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4009
Practice Address - Country:US
Practice Address - Phone:732-970-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02243100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist