Provider Demographics
NPI:1851979850
Name:KITAJ, MAX
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:KITAJ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ALLEN ST UPPR RIGHT
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5307
Mailing Address - Country:US
Mailing Address - Phone:917-261-2177
Mailing Address - Fax:
Practice Address - Street 1:21 ALLEN ST UPPR RIGHT
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5307
Practice Address - Country:US
Practice Address - Phone:917-261-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA2032442084P0800X
NY3178922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry