Provider Demographics
NPI:1154404895
Name:KATZ, BRUCE E (MD)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:E
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EAST 56
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-688-5882
Mailing Address - Fax:212-421-9502
Practice Address - Street 1:60 E 56 STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-688-5882
Practice Address - Fax:212-421-9502
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134724-1207N00000X
NY134724207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY60117GMedicare PIN
NYB80054Medicare UPIN
NY41F911Medicare PIN