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General NPI Number Information
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NPI Number | 1326269416
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Entity Type | Individual
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Provider Name | JAIME H CARCAMO PSY.D
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4322 50TH ST SUITE 2C
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City | WOODSIDE
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State | NY
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Zip | 11377-4442
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Country | US
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Telephone | 718-424-9292
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Fax | 718-424-6199
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Provider Business Mailing Address
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Address Line | 4322 50TH ST SUITE 2C
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City | WOODSIDE
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State | NY
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Zip | 11377-4442
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Country | US
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Telephone | 718-424-9292
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Fax | 718-424-6199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 014573
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License Number State | NY
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