Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X3346 | NY |
NPI | 1306947114 |
---|---|
Provider Name | Dr. Brian J Katz |
First Address | East Rockaway, NY 11518-1530 |
Second Address | East Rockaway, NY 11518-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T52633 | (02) | NY |