Provider Demographics
NPI:1972567899
Name:KAMATH, SANGEETHA (MD)
Entity type:Individual
Prefix:DR
First Name:SANGEETHA
Middle Name:
Last Name:KAMATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 POUND RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1819
Mailing Address - Country:US
Mailing Address - Phone:516-728-7519
Mailing Address - Fax:631-744-5835
Practice Address - Street 1:12 POUND RIDGE RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1819
Practice Address - Country:US
Practice Address - Phone:516-728-7519
Practice Address - Fax:631-744-5835
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225788-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02693965Medicaid
NY02693965Medicaid
I45574Medicare UPIN
NY340AT1Medicare PIN