Provider Demographics
NPI:1912933805
Name:KATZ, WARREN ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:ALLEN
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MAHOGANY WAY
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:UPPER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6084
Mailing Address - Country:US
Mailing Address - Phone:215-300-1337
Mailing Address - Fax:215-699-3535
Practice Address - Street 1:132 MAHOGANY WAY
Practice Address - Street 2:
Practice Address - City:UPPER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19446-6084
Practice Address - Country:US
Practice Address - Phone:215-300-1337
Practice Address - Fax:215-699-3535
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-028324-L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0061686000OtherIBC
PA1070345OtherAETNA
PA018101GC6Medicare ID - Type Unspecified
PA0061686000OtherIBC