Provider Demographics
NPI:1437248333
Name:KAMINSKA, ELIZABETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:KAMINSKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 BLOOMING GROVE TPKE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8135
Mailing Address - Country:US
Mailing Address - Phone:845-561-7902
Mailing Address - Fax:845-561-0025
Practice Address - Street 1:815 BLOOMING GROVE TPKE
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8135
Practice Address - Country:US
Practice Address - Phone:845-561-7902
Practice Address - Fax:845-561-0025
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187767-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF19318Medicare UPIN
NYA400014907Medicare UPIN