Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 058014 | NY |
NPI | 1083955371 |
---|---|
Provider Name | Taryn Katz |
First Address | Forest Hills, NY 11375-2001 |
Second Address | Valley Stream, NY 11580-5252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2013 |
Last Update Date | 05/03/2019 |