Provider Demographics
NPI:1104925858
Name:KATZ, HENRY J (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:J
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1059
Mailing Address - Country:US
Mailing Address - Phone:914-375-0022
Mailing Address - Fax:143-753-7739
Practice Address - Street 1:1254 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1059
Practice Address - Country:US
Practice Address - Phone:914-375-0022
Practice Address - Fax:914-375-3773
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148617207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00904421Medicaid
NY00904421Medicaid
C10303Medicare UPIN