Provider Demographics
NPI:1669760419
Name:BUTTAR, KAMALPREET (MD)
Entity type:Individual
Prefix:
First Name:KAMALPREET
Middle Name:
Last Name:BUTTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-7947
Mailing Address - Fax:631-444-7447
Practice Address - Street 1:4 SMITH HAVEN MALL STE 202
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1219
Practice Address - Country:US
Practice Address - Phone:631-444-7947
Practice Address - Fax:631-444-7447
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2023-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0116024156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine