Provider Demographics
NPI:1205886421
Name:KAMAT, SANJAY D (DO)
Entity type:Individual
Prefix:
First Name:SANJAY
Middle Name:D
Last Name:KAMAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3095 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2500
Mailing Address - Country:US
Mailing Address - Phone:716-896-8831
Mailing Address - Fax:716-896-2318
Practice Address - Street 1:3095 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2500
Practice Address - Country:US
Practice Address - Phone:716-896-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ010190T207W00000X
NY302336207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02883269Medicaid
DE1205886421Medicaid
DE1205886421Medicaid
PA0018751710003Medicaid