Provider Demographics
NPI:1154453207
Name:AMAT, JOSE A (MD,)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:AMAT
Suffix:
Gender:M
Credentials:MD,
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Mailing Address - Street 1:2317 LACONIA AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-1442
Mailing Address - Country:US
Mailing Address - Phone:718-798-2329
Mailing Address - Fax:
Practice Address - Street 1:26 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1602
Practice Address - Country:US
Practice Address - Phone:212-942-1493
Practice Address - Fax:212-567-2019
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2245322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY454BM1Medicare ID - Type UnspecifiedPROVIDER NUMBER