Provider Demographics
NPI:1295878635
Name:KATZ-GERRISH, JULIE BEK (DO)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:BEK
Last Name:KATZ-GERRISH
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 1:40 ROSE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994
Mailing Address - Country:US
Mailing Address - Phone:845-627-1050
Mailing Address - Fax:845-624-4808
Practice Address - Street 1:40 ROSE RD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994
Practice Address - Country:US
Practice Address - Phone:845-627-1050
Practice Address - Fax:845-624-4808
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9X3371Medicare ID - Type Unspecified
G31678Medicare UPIN