Provider Demographics
NPI:1548587587
Name:KAMDAR, JAYANT C (MD)
Entity type:Individual
Prefix:DR
First Name:JAYANT
Middle Name:C
Last Name:KAMDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:C
Other - Last Name:KAMDAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:940 FRAZIER RD
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2408
Mailing Address - Country:US
Mailing Address - Phone:215-852-2077
Mailing Address - Fax:
Practice Address - Street 1:940 FRAZIER RD
Practice Address - Street 2:
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-2408
Practice Address - Country:US
Practice Address - Phone:215-852-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD007971E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine