Individual
KIMTAM VAUGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
68 HARRIS BUSHVILLE RD, HARRIS, NY 12742-0800
(845) 333-8484
(845) 794-5675
Mailing address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-8484
(845) 794-5675
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
262168
NY
208M00000X
Hospitalist Physician
Primary
262168
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03368669
—
NY
Enumeration date
07/08/2011
Last updated
07/13/2021
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