Healthcare Provider Details

I. General information

NPI: 1902663693
Provider Name (Legal Business Name): KAMIL MALSHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 SAWGRASS DR
ROCHESTER NY
14620-4648
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX 656
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2838
  • Fax:
Mailing address:
  • Phone: 401-712-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number333418
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: