Provider Demographics
NPI:1598147282
Name:KATZ, ERIC GREGORY (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:GREGORY
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST STE 416
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5523
Mailing Address - Country:US
Mailing Address - Phone:617-416-8084
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR ST STE 416
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5523
Practice Address - Country:US
Practice Address - Phone:617-416-8084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD91540208800000X
CT71452208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology