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Individual

SAMBASIVA KAMINENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-2473
(718) 275-2673
Mailing address
26 CLUB DR, ROSLYN HEIGHTS, NY 11577-2602
(516) 484-2326

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
214050
NY
2086S0129X
Vascular Surgery Physician
Primary
214050
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007447135
AETNA
NY
01
0199264
GHI
NY
05
02081872
NY
01
162454
ELDERPLAN
NY
01
214050-A53
HEALTHFIRST
NY
01
2323323003
CIGNA
NY
01
34141P
HIP
NY
01
3C3295
HEALTHNET
NY
01
P2214925
OXFORD
NY
Enumeration date
06/22/2005
Last updated
06/15/2019
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