Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 030483 | CT |
NPI | 1245320506 |
---|---|
Provider Name | Dr. Amiram Katz |
First Address | Orange, CT 06477-3559 |
Second Address | Orange, CT 06477-3559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E43159 | (02) | CT |