Provider Demographics
NPI:1659302156
Name:STEWART KAMEN DPM PC
Entity Type:Organization
Organization Name:STEWART KAMEN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-337-6755
Mailing Address - Street 1:77 PONDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3809
Mailing Address - Country:US
Mailing Address - Phone:914-337-6755
Mailing Address - Fax:914-337-6756
Practice Address - Street 1:77 PONDFIELD RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-337-6755
Practice Address - Fax:914-337-6756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004743213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02241252Medicaid
NY02978352Medicaid
NY02996716Medicaid
NYPUW972Medicare ID - Type Unspecified
NY02978352Medicaid
NY02996716Medicaid
NY0910440001Medicare NSC