Provider Demographics
NPI:1447843503
Name:KATZ, MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W 94TH ST APT 7E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6963
Mailing Address - Country:US
Mailing Address - Phone:516-987-6046
Mailing Address - Fax:
Practice Address - Street 1:169 W 133RD ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-3301
Practice Address - Country:US
Practice Address - Phone:646-762-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty