Provider Demographics
NPI:1306275383
Name:KAMLET, JEROME (MD)
Entity type:Individual
Prefix:
First Name:JEROME
Middle Name:
Last Name:KAMLET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CABRINI BLVD
Mailing Address - Street 2:APT74
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1137
Mailing Address - Country:US
Mailing Address - Phone:212-781-6455
Mailing Address - Fax:
Practice Address - Street 1:160 CABRINI BLVD
Practice Address - Street 2:APT74
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1137
Practice Address - Country:US
Practice Address - Phone:212-781-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090019207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine