Provider Demographics
NPI:1891108726
Name:KATZ, RUTHE (MA)
Entity Type:Individual
Prefix:
First Name:RUTHE
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13786 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1926
Mailing Address - Country:US
Mailing Address - Phone:917-572-4892
Mailing Address - Fax:
Practice Address - Street 1:13786 70TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1926
Practice Address - Country:US
Practice Address - Phone:917-572-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool