Provider Demographics
NPI:1245240670
Name:KAMHI, EDOUARD (MD)
Entity Type:Individual
Prefix:
First Name:EDOUARD
Middle Name:
Last Name:KAMHI
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 1:5 CUBA HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1624
Mailing Address - Country:US
Mailing Address - Phone:631-628-5000
Mailing Address - Fax:
Practice Address - Street 1:325 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2779
Practice Address - Country:US
Practice Address - Phone:631-351-3728
Practice Address - Fax:631-385-1046
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115930-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00425094Medicaid
NY0500088OtherGHI
NYCS106OtherOXFORD
NY2C4863OtherHEALTHNET
NY584851OtherBLUE CROSS/ BLUE SHIELD
NY0500088OtherGHI
NY584851Medicare ID - Type Unspecified