Provider Demographics
NPI:1053439562
Name:KATZEN, EVE M (PA-C)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:M
Last Name:KATZEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:247 W 15TH ST
Mailing Address - Street 2:APT 2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6461
Mailing Address - Country:US
Mailing Address - Phone:347-925-6909
Mailing Address - Fax:
Practice Address - Street 1:713 N DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-2830
Practice Address - Country:US
Practice Address - Phone:310-906-2788
Practice Address - Fax:310-906-2786
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY009551-1363A00000X
CA55474363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant