Provider Demographics
NPI:1447287313
Name:KATZ, LLOYD CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:CHARLES
Last Name:KATZ
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 1:3 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-6311
Mailing Address - Country:US
Mailing Address - Phone:607-319-0813
Mailing Address - Fax:607-319-0813
Practice Address - Street 1:3 PHEASANT LN
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-6311
Practice Address - Country:US
Practice Address - Phone:607-319-0813
Practice Address - Fax:607-319-0813
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA206642OtherANTHEM
VA00Y1143A01OtherMEDICARE INDIVIDUAL PTAN