Provider Demographics
NPI:1972804912
Name:JAYESH KAMDAR, MD
Entity type:Organization
Organization Name:JAYESH KAMDAR, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST/PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAMDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-695-2908
Mailing Address - Street 1:9978 65TH RD
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3655
Mailing Address - Country:US
Mailing Address - Phone:718-685-2908
Mailing Address - Fax:718-685-2991
Practice Address - Street 1:99-78 65TH ROAD
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-685-2908
Practice Address - Fax:718-685-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1644572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty