Provider Demographics
NPI:1831453737
Name:HOLMAN, CAMILLE SUSAN (MSED SAS SDA)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:SUSAN
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:MSED SAS SDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 1ST AVE
Mailing Address - Street 2:APT. 2H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2619
Mailing Address - Country:US
Mailing Address - Phone:917-862-5881
Mailing Address - Fax:
Practice Address - Street 1:270 1ST AVE
Practice Address - Street 2:APT. 2H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2619
Practice Address - Country:US
Practice Address - Phone:917-862-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist