Provider Demographics
NPI:1396876546
Name:ALEX S. KATZ DPM, LLC
Entity type:Organization
Organization Name:ALEX S. KATZ DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:S
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-380-8008
Mailing Address - Street 1:15028 UNION TPKE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3900
Mailing Address - Country:US
Mailing Address - Phone:718-380-8008
Mailing Address - Fax:718-380-2229
Practice Address - Street 1:15028 UNION TPKE
Practice Address - Street 2:SUITE 150
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3900
Practice Address - Country:US
Practice Address - Phone:718-380-8008
Practice Address - Fax:718-380-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005336213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU67244Medicare UPIN
NYPQW131Medicare ID - Type Unspecified