Basic Information
Provider Information
NPI: 1144297458
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KATZ
FirstName: RICHARD
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 121 EVERETT RD
Address2: SUITE 100
City: ALBANY
State: NY
PostalCode: 122051417
CountryCode: US
TelephoneNumber: 5184539088
FaxNumber: 5186896111
Practice Location
Address1: 121 EVERETT RD
Address2: SUITE 100
City: ALBANY
State: NY
PostalCode: 122051417
CountryCode: US
TelephoneNumber: 5184539088
FaxNumber: 5186896111
Other Information
ProviderEnumerationDate: 03/06/2006
LastUpdateDate: 05/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X187047NYY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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