Provider Demographics
NPI:1518944966
Name:KAMIN, HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:KAMIN
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 1:40 JON BARRETT RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2164
Mailing Address - Country:US
Mailing Address - Phone:845-878-9078
Mailing Address - Fax:845-878-3203
Practice Address - Street 1:40 JON BARRETT RD
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2164
Practice Address - Country:US
Practice Address - Phone:845-878-9078
Practice Address - Fax:845-878-3203
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00131984Medicaid
NYB80526Medicare UPIN
NY161931Medicare ID - Type Unspecified
NY00131984Medicaid