Provider Demographics
NPI:1861580284
Name:KATZEN, STUART E (DC)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:E
Last Name:KATZEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MONTGOMERY CHIROPRACTIC
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072
Mailing Address - Country:US
Mailing Address - Phone:610-664-8330
Mailing Address - Fax:610-664-6334
Practice Address - Street 1:915 MONTGOMERY CHIROPRACTIC
Practice Address - Street 2:SUITE 109
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072
Practice Address - Country:US
Practice Address - Phone:610-664-8330
Practice Address - Fax:610-664-6334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007069L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0437383000OtherPERSONL CHOICE
PA0437383000OtherPERSONL CHOICE