Center for Dynamic Aging, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA063457 Issued in NJ

Legal business name

CENTER FOR DYNAMIC AGING, LLC

Practice address

1530 Palisade Ave
Fort Lee, NJ 07024-5471

Phone

(201) 363-8871

Fax

(201) 363-8873

NPI assigned

May 31, 2013

Last updated

May 31, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Terri F Katz, M.D.,NPI 1588764005

Title

President

Phone

(201) 363-8871

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terri Feldman Katz, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Fort Lee, NJ
  • NPI 1588764005
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1235576109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-363-8871",
            "fax_number": "201-363-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-363-8871",
            "fax_number": "201-363-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DYNAMIC AGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-363-8871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA063457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan E Campbell-Tatulli, RDN
• Risory Caraballo, MSW
• Vincent Carrao, DDS, MD
• Joseph Philip Cassotta, MD
• Center for Behavioral Health & Wellness LLC
• Center for Human Growth & Devlp
• Center for Lower Extremity Wellness
• Center for Psychological & Forensic Services Inc
• Centurylink Transportation, LLC
• Dorothy Kyungae Chae, L. AC

• Internal Medicine Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.