Provider Demographics
NPI:1427290329
Name:KATZ, BORIS (PT)
Entity type:Individual
Prefix:
First Name:BORIS
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2719
Mailing Address - Country:US
Mailing Address - Phone:917-658-8284
Mailing Address - Fax:973-732-3445
Practice Address - Street 1:56 GRAFTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-4215
Practice Address - Country:US
Practice Address - Phone:973-732-3444
Practice Address - Fax:973-732-3445
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021289225100000X
NJ40QA01356400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist