Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD045793L | PA |
NPI | 1033128632 |
---|---|
Provider Name | Dr. Ian Katz |
First Address | Johnstown, PA 15905-2832 |
Second Address | Johnstown, PA 15905-2832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 07/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013955600001 | (05) | PA |
F46867 | (02) | PA |