Provider Demographics
NPI:1003454117
Name:AIT BELKACEM, KAMILIA (PA)
Entity Type:Individual
Prefix:
First Name:KAMILIA
Middle Name:
Last Name:AIT BELKACEM
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:3811 DITMARS BLVD APT 420
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1803
Mailing Address - Country:US
Mailing Address - Phone:347-862-8380
Mailing Address - Fax:
Practice Address - Street 1:2510 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2448
Practice Address - Country:US
Practice Address - Phone:347-862-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2020-03-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant