Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 45PO00017200 | NJ |
N | 222Z00000X | Podiatrist | 45PO00017200 | NJ |
Y | 224P00000X | Prosthetist | 45PO00017200 | NJ |
NPI | 1417459249 |
---|---|
Provider Name | Eric Brian Katz |
First Address | Toms River, NJ 08753-2034 |
Second Address | Linwood, NJ 08221-1371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2018 |
Last Update Date | 07/03/2018 |