Provider Demographics
NPI:1326284506
Name:DIMITROVA, KAMELLIA RANGELOVA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMELLIA
Middle Name:RANGELOVA
Last Name:DIMITROVA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 95000-2424
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2424
Mailing Address - Country:US
Mailing Address - Phone:212-420-2584
Mailing Address - Fax:212-420-2330
Practice Address - Street 1:317 E 17TH ST
Practice Address - Street 2:DIV OF CARDIAC SURGERY-FIERMAN HALL-11 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-420-2584
Practice Address - Fax:212-420-2330
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2012-12-19
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Provider Licenses
StateLicense IDTaxonomies
NY003249-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)