Provider Demographics
NPI:1669813358
Name:KATZ, JEFFREY ADAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ADAM
Last Name:KATZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-0921
Mailing Address - Country:US
Mailing Address - Phone:908-601-1400
Mailing Address - Fax:
Practice Address - Street 1:803 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-0921
Practice Address - Country:US
Practice Address - Phone:908-601-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03563500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03563500OtherNJ STATE PHARMACIST LICENSE