Provider Demographics
NPI:1790766541
Name:EDWARD KATIME, M.D.,P.C.
Entity Type:Organization
Organization Name:EDWARD KATIME, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KATIME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-222-1616
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-1616
Mailing Address - Fax:516-222-0437
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-222-1616
Practice Address - Fax:516-222-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0061915OtherGHI INSURANCE
NY131154OtherGREAT WEST ONE HEALTH PLA
NYAL46518OtherMDNY
NY04001367OtherRAILROAD MEDICARE
NYOC6302OtherHEALTH NET INSURANCE
NY00946263Medicaid
NY10-00001OtherUNITED HEALTHCARE
NY449OtherVYTRA
NY53593OtherGHI HMO
NY65A311OtherEMPIRE BLUECROSS & BLUESH
NYAS1107OtherOXFORD HEALTH PLANS
NY65A311OtherEMPIRE BLUECROSS & BLUESH
NY449OtherVYTRA