Provider Demographics
NPI:1801189006
Name:MAZEN O KAMEN, M.D. P.C.
Entity Type:Organization
Organization Name:MAZEN O KAMEN, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:O
Authorized Official - Last Name:KAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-427-5800
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0959
Mailing Address - Country:US
Mailing Address - Phone:212-427-5800
Mailing Address - Fax:212-996-9943
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0959
Practice Address - Country:US
Practice Address - Phone:212-427-5800
Practice Address - Fax:212-996-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162751207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60965Medicare UPIN
NY17E651Medicare PIN