Provider Demographics
NPI:1144402033
Name:STEVEN M KATZ, MD, LLC
Entity type:Organization
Organization Name:STEVEN M KATZ, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-231-2850
Mailing Address - Street 1:11 MELROSE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2291
Mailing Address - Country:US
Mailing Address - Phone:860-231-2850
Mailing Address - Fax:860-586-7422
Practice Address - Street 1:11 MELROSE DR STE 203
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2291
Practice Address - Country:US
Practice Address - Phone:860-231-2850
Practice Address - Fax:869-586-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0344382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03510Medicare PIN