Provider Demographics
NPI:1902836331
Name:KATOF, ADAM MARC (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MARC
Last Name:KATOF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:100 MANETTO HILL RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1311
Mailing Address - Country:US
Mailing Address - Phone:516-513-1720
Mailing Address - Fax:516-513-1722
Practice Address - Street 1:100 MANETTO HILL RD
Practice Address - Street 2:SUITE 312
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1311
Practice Address - Country:US
Practice Address - Phone:516-513-1720
Practice Address - Fax:516-513-1722
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2012-01-10
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Provider Licenses
StateLicense IDTaxonomies
NY218967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02458868Medicaid
NY02458868Medicaid
NYI01520Medicare UPIN