Provider Demographics
NPI:1518919661
Name:KAW, PAMELA (MD)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:KAW
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 1:16 WEISHEIT RD
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-4000
Mailing Address - Country:US
Mailing Address - Phone:518-378-7797
Mailing Address - Fax:
Practice Address - Street 1:10 STARBUCK DR STE 208
Practice Address - Street 2:
Practice Address - City:GREEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:12183-1280
Practice Address - Country:US
Practice Address - Phone:518-274-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239161207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI51805Medicare ID - Type Unspecified
NYRB80250Medicare UPIN