Basic Information
| Provider Information | |||||||||
| NPI: | 1144338336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KATZ | ||||||||
| FirstName: | GIORA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 SALINA MEADOWS PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132124516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154642000 | ||||||||
| FaxNumber: | 3154642010 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 HARRISON ST. | ||||||||
| Address2: | SUITE M | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154641500 | ||||||||
| FaxNumber: | 3154646117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2006 | ||||||||
| LastUpdateDate: | 03/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 42243 | WI | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 243475 | NY | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 14831 | 01 | WI | NETWORK HEALTH PLAN | OTHER | 34420600 | 05 | WI | MEDICAID | P00055664 | 01 | WI | RAILROAD MEDICARE | OTHER | 42243 | 01 | WI | TOUCHPOINT | OTHER | H92426 | 01 | WI | CIGNA | OTHER | 3908063950B1 | 01 | WI | BLUE CROSS BLUE SHIELD | OTHER | W004685 | 01 | WI | CHAMPUS | OTHER |