Provider Demographics
NPI:1659367522
Name:KATZ, JOSHUA D (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:D
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 1:110 CEDAR ST STE 110
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3527
Mailing Address - Country:US
Mailing Address - Phone:781-591-8300
Mailing Address - Fax:781-591-8320
Practice Address - Street 1:110 CEDAR ST STE 110
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3527
Practice Address - Country:US
Practice Address - Phone:781-591-8300
Practice Address - Fax:781-591-8320
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA798072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3194108Medicaid
MA3194108Medicaid
G70501Medicare UPIN