Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 22DI02546200 | NJ |
NPI | 1255636155 |
---|---|
Provider Name | Mohamed Samy Kamel |
First Address | West Orange, NJ 07052-1501 |
Second Address | Newark, NJ 07103-2495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2011 |
Last Update Date | 25/04/2016 |