Provider Demographics
NPI:1043213440
Name:KAMENETSKY, ALEKSEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEKSEY
Middle Name:
Last Name:KAMENETSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LINKS DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5623
Mailing Address - Country:US
Mailing Address - Phone:718-332-3220
Mailing Address - Fax:718-332-5413
Practice Address - Street 1:4766A BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2606
Practice Address - Country:US
Practice Address - Phone:718-332-3220
Practice Address - Fax:718-332-5413
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199817207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1932874OtherUNITED HEALTHCARE
NY2069053OtherAETNA HMO
NY3C5308OtherHEALTHNET
NY5342662OtherAETNA PPO
NY137334POtherHIP
NY2199760OtherGHI
NYP2084192OtherOXFORD
NY44J192OtherEMPIRE BLUE CROSS BLUE SH
NY01605169Medicaid
NY01605169Medicaid