Provider Demographics
NPI:1336220979
Name:KENAMORE, SARA F (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:F
Last Name:KENAMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:99 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1564
Mailing Address - Country:US
Mailing Address - Phone:914-428-2120
Mailing Address - Fax:914-428-1989
Practice Address - Street 1:99 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1564
Practice Address - Country:US
Practice Address - Phone:914-428-2120
Practice Address - Fax:914-428-1989
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212213208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02220868Medicaid
NY2449043OtherAETNA HMO
NY2C6918OtherHEALTH NET
NY7205126OtherAETNA PPO
NY15247OtherHEALTH SOURCE
NY132625705OtherEMPIRE PLAN
NY132625705OtherUNITED
NY3768299002OtherCIGNA
NMP2076447OtherOXFORD
NY0B4031OtherEMPIRE BCBS
NM132625705OtherPOMCO