1952411340 NPI number — AMOS KATZ MD

Table of content: AMOS KATZ MD (NPI 1952411340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952411340 NPI number — AMOS KATZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATZ
Provider First Name:
AMOS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1952411340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 W MAIN ST STE 364
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREEHOLD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07728-2537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-294-2505
Provider Business Mailing Address Fax Number:
732-308-3562

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 HIGHWAY 35
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EATONTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07724-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-798-3620
Provider Business Practice Location Address Fax Number:
732-879-3619
Provider Enumeration Date:
08/30/2006

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: 2084N0400X , with the licence number:  25MA04219600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0558702 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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