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Provider Information for 1982604799


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JAYESH R KAMATH MD


Sex: Male

NPI: 1982604799
Last Updated: 2022-09-30
Certification Date:

Details

NameValue
NPI1982604799
Enumeration Date2005-07-22
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 263 FARMINGTON AVE
PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
United States

Phone: 860-679-7503 | Fax:860-679-1610
 
Primary Practice Address 263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
United States

Phone: 860-679-6700 | Fax:860-679-6736
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
jkamath10815@direct.med.uchc.edu
Uconn Medical Group
Farmington, CT 06030-0001
United States
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCT1131028
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 2084P0800X - Psychiatry & Neurology - PsychiatryCT042994