Healthcare Provider Details

I. General information

NPI: 1447246970
Provider Name (Legal Business Name): HIDEKO KAMINO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST 11 FLOOR
NEW YORK NY
10016-2708
US

IV. Provider business mailing address

240 E 38TH ST 11 FLOOR
NEW YORK NY
10016-2708
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7250
  • Fax:
Mailing address:
  • Phone: 212-263-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number161915
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number161915
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: