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NPI Code Detail

MEDICARE: JESSICA KAMIN

MEDICARE: JESSICA KAMIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1376326876
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA KAMIN
Provider Business Mailing Address
First Line : 64 LAWRENCE AVE
Second Line :
City : LAWRENCE
State : NY
Zip : 11559-1447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 365 WILLOUGHBY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-5191
Country : US
Telephone Number : 718-875-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2023
Last Update Date : 08/17/2023

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Directions to “ JESSICA KAMIN ” Practice Location

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