Provider Demographics
NPI:1205839917
Name:KAMLET, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:KAMLET
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 1:345 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1145
Mailing Address - Country:US
Mailing Address - Phone:212-581-4797
Mailing Address - Fax:212-247-2783
Practice Address - Street 1:345 W 58TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1145
Practice Address - Country:US
Practice Address - Phone:212-581-4797
Practice Address - Fax:212-247-2783
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153422171100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01093232Medicaid
NY34E901Medicare ID - Type UnspecifiedPROVIDER ID#
NY01093232Medicaid