Healthcare Provider Details

I. General information

NPI: 1881884906
Provider Name (Legal Business Name): DR. ARTHUR MARK KAMMERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 7TH ST STE. 301
GARDEN CITY NY
11530-5723
US

IV. Provider business mailing address

226 7TH ST STE. 301
GARDEN CITY NY
11530-5723
US

V. Phone/Fax

Practice location:
  • Phone: 516-742-4110
  • Fax: 516-742-3804
Mailing address:
  • Phone: 516-742-4110
  • Fax: 516-742-3804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number039274
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: