Provider Demographics
NPI:1992858096
Name:KATZ, OLGA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 WINTHROP PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3043
Mailing Address - Country:US
Mailing Address - Phone:718-727-7077
Mailing Address - Fax:718-727-7673
Practice Address - Street 1:38 WINTHROP PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3043
Practice Address - Country:US
Practice Address - Phone:718-727-7077
Practice Address - Fax:718-727-7673
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2079232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01867821Medicaid
NY01867821Medicaid
NY58M011Medicare ID - Type Unspecified