Provider Demographics
NPI:1972649168
Name:CAMACHO, ARTEMIO (MD)
Entity type:Individual
Prefix:
First Name:ARTEMIO
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 BARKER AVE
Mailing Address - Street 2:APT 1B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8052
Mailing Address - Country:US
Mailing Address - Phone:347-275-3457
Mailing Address - Fax:
Practice Address - Street 1:545 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2110
Practice Address - Country:US
Practice Address - Phone:718-579-1718
Practice Address - Fax:718-579-4009
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214636208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY214636OtherMD