Provider Demographics
NPI:1982673042
Name:KAMENY, STUART MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:MATTHEW
Last Name:KAMENY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1114
Mailing Address - Street 2:CMS, INC
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1114
Mailing Address - Country:US
Mailing Address - Phone:508-763-9299
Mailing Address - Fax:508-763-9517
Practice Address - Street 1:863 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 46
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3009
Practice Address - Country:US
Practice Address - Phone:617-492-7788
Practice Address - Fax:508-358-5056
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA281502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3109461Medicaid
MA722856OtherTUFTS HEALTH PLAN
MAHP2205895OtherPACIFIC CARE
MAM07879OtherBLUE CROSS BLUE SHIEL
MAM07879OtherBLUE CROSS BLUE SHIEL
MA3109461Medicaid