Provider Demographics
NPI:1801995790
Name:KATZ, HERBERT I (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:I
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 1:534 AVENUE E
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3987
Mailing Address - Country:US
Mailing Address - Phone:201-823-1303
Mailing Address - Fax:201-823-0944
Practice Address - Street 1:534 AVENUE E
Practice Address - Street 2:SUITE 2A
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3987
Practice Address - Country:US
Practice Address - Phone:201-823-1303
Practice Address - Fax:201-823-0944
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03586600208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC55824Medicare UPIN
NJ014361Medicare ID - Type UnspecifiedMEDICARE PROVIDER #