1275640435 NPI number — STEVEN LEE KATZ DO

Table of content: (NPI 1306033618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275640435 NPI number — STEVEN LEE KATZ DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATZ
Provider First Name:
STEVEN
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275640435
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 HAMILTON ST STE 317
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-6359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-481-9600
Provider Business Mailing Address Fax Number:
610-481-0225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 HAMILTON ST STE 317
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-6359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-481-9600
Provider Business Practice Location Address Fax Number:
610-481-0225
Provider Enumeration Date:
08/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  OS004894L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0010780900008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".