Healthcare Provider Details

I. General information

NPI: 1053542332
Provider Name (Legal Business Name): ANNE MARIE KAMINSKY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POLY PL VHA,DEPT.RADIATION ONCOLOGY
BROOKLYN NY
11209-7104
US

IV. Provider business mailing address

450 CLARKSON AVE DOWNSTATE MED. CTR. DEPT. RADIATION ONCOLOGY, BOX #1211
BROOKLYN NY
11203-2056
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-3605
  • Fax: 718-630-2857
Mailing address:
  • Phone: 718-221-6956
  • Fax: 718-270-1535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number309072-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: