Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 22263 | MS |
N | 2084N0400X | Neurologist | 47044 | TN |
N | 2084N0400X | Neurologist | E-8511 | AR |
Y | 2084V0102X | Vascular Neurology | ME107144 | FL |
NPI | 1013170067 |
---|---|
Provider Name | Michael J. Katsnelson |
First Address | Ventura, CA 93003-6451 |
Second Address | Vienna, VA 22182-6207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 30/03/2021 |