Provider Demographics
NPI:1134160146
Name:KATZ, MARTIN E (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:E
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:19 LUNAR DRIVE
Mailing Address - Street 2:MEDICAL ONCOLOGY & HEMATOLOGY, PC
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525
Mailing Address - Country:US
Mailing Address - Phone:203-389-7504
Mailing Address - Fax:203-389-1666
Practice Address - Street 1:2080 WHITNEY AVENUE, SUITE 240
Practice Address - Street 2:MEDICAL ONCOLOGY & HEMATOLOGY, PC
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-407-8002
Practice Address - Fax:203-407-8038
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT018670207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001186909Medicaid
CTD400059246Medicare PIN
CT001186909Medicaid