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General NPI Number Information
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NPI Number | 1205100237
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Entity Type | Organization
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Legal Business Name | PAMELA KAW MD
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 12/26/2021
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Provider Practice Location Address
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Address Line | 10 STARBUCK DR
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City | GREEN ISLAND
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State | NY
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Zip | 12183-1280
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Country | US
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Telephone | 518-274-3390
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Fax | 518-274-3398
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Provider Business Mailing Address
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Address Line | 451 HOOSICK ST
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City | TROY
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State | NY
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Zip | 12180-2100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAMELA KAW
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Credential |
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Telephone | 518-274-3390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 239161
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License Number State | NY
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