Provider Demographics
NPI:1023329299
Name:KAMENETZ, FLAVIO ROBERTO (MD-PHD)
Entity type:Individual
Prefix:DR
First Name:FLAVIO
Middle Name:ROBERTO
Last Name:KAMENETZ
Suffix:
Gender:M
Credentials:MD-PHD
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Mailing Address - Street 1:1200 WATERS PL
Mailing Address - Street 2:STE M108
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2728
Mailing Address - Country:US
Mailing Address - Phone:718-931-5620
Mailing Address - Fax:718-824-0706
Practice Address - Street 1:1200 WATERS PL
Practice Address - Street 2:STE M108
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2728
Practice Address - Country:US
Practice Address - Phone:718-931-5620
Practice Address - Fax:718-824-0706
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2012-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2389902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology