Most Relevant Information
Provider Data
| NPI Number: | 1003694696 |
| Provider Name: | CAM THAI |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 030496-01 |
Most Important Dates
| Enumeration Date: | 09/15/2023 |
| Last Updated: | 10/27/2023 |
Provider Practice Location
1468 MADISON AVE
NEW YORK
NY
100296508
Practice Location Phone/Fax
| Phone: | 2122416500 |
| Fax: |
Provider Mailing Location
11 WHARTON LN
CHELTENHAM
PA
190121216
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |