Provider Demographics
NPI:1215748447
Name:KATZEN MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:KATZEN MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-915-5202
Mailing Address - Street 1:3401 BOX HILL CORPORATE CENTER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-0000
Mailing Address - Country:US
Mailing Address - Phone:410-569-0707
Mailing Address - Fax:410-569-0711
Practice Address - Street 1:3401 BOX HILL CORPORATE CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1200
Practice Address - Country:US
Practice Address - Phone:410-569-0707
Practice Address - Fax:410-569-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty