Provider Demographics
NPI:1750381174
Name:KAMINENI, SANTHA (MD)
Entity type:Individual
Prefix:
First Name:SANTHA
Middle Name:
Last Name:KAMINENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2602
Mailing Address - Country:US
Mailing Address - Phone:516-484-2326
Mailing Address - Fax:718-275-2673
Practice Address - Street 1:9525 QUEENS BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4510
Practice Address - Country:US
Practice Address - Phone:718-275-2672
Practice Address - Fax:718-275-2673
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217178207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2029761OtherUNITED HEALTHCARE
0100086-08OtherAMERICHOICE
0296876OtherGHI
P2478311OtherOXFORD
SK0705C810OtherBLUECROSS
2234716002OtherCIGNA
NY02098039Medicaid
3C4804OtherHEALTHNET
0007863210OtherAETNA
175158OtherELDERPLAN
P2478311OtherOXFORD