Provider Demographics
NPI:1568631273
Name:KANOFSKY, JAMIE A (MD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:KANOFSKY
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 1:462 FIRST AVENUE
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-562-3874
Mailing Address - Fax:212-562-3875
Practice Address - Street 1:462 FIRST AVENUE
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-3874
Practice Address - Fax:212-562-3875
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236253208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY236253OtherLICENSE