Healthcare Provider Details

I. General information

NPI: 1194838698
Provider Name (Legal Business Name): VICTORIA CAMAYA, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 ROUTE 134 SUITE C-2
SOUTH DENNIS MA
02660-3433
US

IV. Provider business mailing address

434 ROUTE 134 SUITE C-2
SOUTH DENNIS MA
02660-3433
US

V. Phone/Fax

Practice location:
  • Phone: 508-398-3617
  • Fax:
Mailing address:
  • Phone: 508-398-3617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number220509
License Number StateMA

VIII. Authorized Official

Name: VICTORIA M CAMAYA
Title or Position: PRESIDENT
Credential: MD
Phone: 508-398-3617