Provider Demographics
NPI:1871540328
Name:KATZ, RANDI JOY (DO)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:JOY
Last Name:KATZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:1608 ROUTE 88 WEST
Practice Address - Street 2:SUITE 250
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724
Practice Address - Country:US
Practice Address - Phone:732-840-8880
Practice Address - Fax:732-840-3939
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08211700207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223172739OtherTAX ID
NJ0151319Medicaid