Provider Demographics
NPI:1366638439
Name:KATCHIS, STUART D (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:D
Last Name:KATCHIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:130 E 77TH ST
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1851
Mailing Address - Country:US
Mailing Address - Phone:212-434-4920
Mailing Address - Fax:212-434-2844
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-434-4920
Practice Address - Fax:212-434-2844
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2008-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY190026207X00000X, 207XX0004X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY118991Medicare PIN
NYG00496Medicare UPIN
NY5655050001Medicare NSC