Provider Demographics
NPI:1386745271
Name:KATZ, SOLOMON (EDD)
Entity type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 TAHANTO TRL
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-1630
Mailing Address - Country:US
Mailing Address - Phone:978-345-7705
Mailing Address - Fax:978-456-9130
Practice Address - Street 1:84 TAHANTO TRL
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1630
Practice Address - Country:US
Practice Address - Phone:978-345-7705
Practice Address - Fax:978-456-9130
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5020103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0520322Medicaid
MA719791OtherTUFTS HEALTH PLANS
MA96685101Medicaid
062871000OtherMAGELLAN
MAW04729OtherBLUE CROSS BLUE SHIELD
MA0520322Medicaid