Provider Demographics
NPI:1730573205
Name:KAM PRIMARY CARE, P.C.
Entity type:Organization
Organization Name:KAM PRIMARY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YI SHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:KAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-328-3764
Mailing Address - Street 1:24812 NORTHERN BLVD
Mailing Address - Street 2:2A
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24812 NORTHERN BLVD
Practice Address - Street 2:2A
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1206
Practice Address - Country:US
Practice Address - Phone:347-328-3764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262586261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care