Healthcare Provider Details

I. General information

NPI: 1962721092
Provider Name (Legal Business Name): DOROTA KAMINSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 MEDICAL DR SUITE E
POTTSTOWN PA
19464-3247
US

IV. Provider business mailing address

1590 MEDICAL DR SUITE E
POTTSTOWN PA
19464-3247
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-4980
  • Fax:
Mailing address:
  • Phone: 610-326-4980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT196373
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD449045
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: