MEDICARE: IRA CAMHI, D.D.S., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	028638	NY

General Provider Information

NPI Number	:	1386769073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRA CAMHI, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	621 KATAN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3422
Country	:	US
Telephone Number	:	718-948-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	621 KATAN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3422
Country	:	US
Telephone Number	:	718-948-4000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. IRA CAMHI
Credential	:	DDS
Telephone Number	:	718-948-4000

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/22/2020

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