Provider Demographics
NPI:1265478333
Name:KAMEN, BRUCE ELIAS (DPM)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ELIAS
Last Name:KAMEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1762 GARWOOD DRIVE
Mailing Address - Street 2:BRUCE E KAMEN DPM
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3206
Mailing Address - Country:US
Mailing Address - Phone:856-904-3393
Mailing Address - Fax:856-616-1352
Practice Address - Street 1:1902 CHAMPLAIN DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2871
Practice Address - Country:US
Practice Address - Phone:856-904-3393
Practice Address - Fax:856-616-1352
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00139800213E00000X
DEE10000130213E00000X
PASC002449L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009510540003Medicaid
DE480003154OtherRR MC
DE0000823017Medicaid
NJ024974OtherMEDICARE
NJ480003154OtherRR MC
NJ5588201Medicaid
PA448333OtherMEDICARE
PA480003154OtherRR MC
PA480003154OtherRR MC
PA0009510540003Medicaid