Provider Demographics
NPI:1821073123
Name:KATZ, JACQUELINE IRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:IRIS
Last Name:KATZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 N PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1771
Mailing Address - Country:US
Mailing Address - Phone:413-259-1169
Mailing Address - Fax:413-259-1170
Practice Address - Street 1:236 N PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1771
Practice Address - Country:US
Practice Address - Phone:413-259-1169
Practice Address - Fax:413-250-1170
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39679OtherBLUE CROSS GROUP
MAY35890OtherBLUE CROSS
MAY39679OtherBLUE CROSS GROUP