Provider Demographics
NPI:1770526329
Name:KATZ, HOWARD MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:MICHAEL
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 1:216 GARDNER ROAD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-4560
Mailing Address - Country:US
Mailing Address - Phone:617-877-2629
Mailing Address - Fax:888-429-1617
Practice Address - Street 1:216 GARDNER ROAD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4560
Practice Address - Country:US
Practice Address - Phone:617-877-2629
Practice Address - Fax:888-429-1617
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA383952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC04720OtherBC/BS
MAC04720OtherBC/BS
B95213Medicare UPIN