Healthcare Provider Details

I. General information

NPI: 1669685798
Provider Name (Legal Business Name): AVRAHAM KADAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 LEXINGTON AVE SUITE 102
MOUNT KISCO NY
10549-3632
US

IV. Provider business mailing address

666 LEXINGTON AVE SUITE 102
MOUNT KISCO NY
10549-3632
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-3456
  • Fax: 914-666-9167
Mailing address:
  • Phone: 914-666-3456
  • Fax: 914-666-9167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number167811
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: