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General NPI Number Information
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NPI Number | 1669698841
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Entity Type | Individual
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Provider Name | JOSE CAMACHO D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 75 S BROADWAY STE 406
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4413
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Country | US
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Telephone | 212-966-6655
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Fax | 914-304-4223
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Provider Business Mailing Address
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Address Line | 75 S BROADWAY STE 406
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4413
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Country | US
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Telephone | 212-966-6655
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Fax | 914-304-4223
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7761
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 278394
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 278394
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License Number State | NY
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