Provider Demographics
NPI:1982672812
Name:KATZ, JAMIE BETH (DO)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:BETH
Last Name:KATZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820890
Mailing Address - Street 2:TEMPLE PEDIATRIC EMERGENCY MEDICAL ASSOCIATES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0890
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:3509 N BROAD STREET
Practice Address - Street 2:TEMPLE UNIVERSITY CHILDRENS MEDICAL CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:215-707-6606
Practice Address - Fax:215-707-6629
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007262L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012183080001Medicaid
PA425075OtherHIGHMARK BS
PA1012183080001Medicaid
I18612Medicare UPIN